title: Complications associated with the arterial puncture closure device--Angio-Seal.
abstract: BACKGROUND
  Arterial puncture closure devices (APCD) are frequently used after cardiac catheterization. Here, the diagnosis and therapy of femoral artery complications after the use of the Angio-Seal APCD is reported.
  
  
  METHODS
  The Angio-Seal APCD was deployed in 1600 patients undergoing transfemoral catheterization.
  
  
  RESULTS
  In 7 of 1600 cases (0.4%) vascular complications occurred following Angio-Seal deployment. Diagnosis was made by duplex sonography. Intraoperative findings consisted of a complete occlusion with dissection of the femoral artery in all patients. In 6 cases, the femoral bifurcation had to be reconstructed after endarterectomy. Follow-up is complete with a mean of 6 months.
  
  
  CONCLUSIONS
  The Angio-Seal device should not be used for closure of the superficial femoral artery and in patients with severe arteriosclerosis. The application of arteriography as well as the use of ultrasound-guided puncture is advisable. In all cases, surgical intervention was successful and an adequate therapy for management of complications.
authors.affiliation: Swiss Cardiovascular Center, University Hospital, Freiburgerstrasse, Bern, Switzerland. alexander.kadner@insel.ch
authors.forename: Alexander
authors.initials: A
authors.lastname: Kadner
authors.forename: Jürg
authors.initials: J
authors.lastname: Schmidli
authors.forename: Igor
authors.initials: I
authors.lastname: Schwegler
authors.forename: Florian
authors.initials: F
authors.lastname: Dick
authors.forename: Florian
authors.initials: F
authors.lastname: Schönhoff
authors.forename: Thierry
authors.initials: T
authors.lastname: Carrel
authors.forename: Hannu
authors.initials: H
authors.lastname: Savolainen
mesh_terms: D000368:Aged; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D006328:Cardiac Catheterization; D002406:Catheterization, Peripheral; D004691:Endarterectomy; D004867:Equipment Design; D000071938:Fasciotomy; D005260:Female; D005263:Femoral Artery; D006470:Hemorrhage / Q000209:etiology / Q000517:prevention & control*; D006489:Hemostatic Techniques / Q000009:adverse effects* / Q000295:instrumentation; D006801:Humans; D008297:Male; D011677:Punctures / Q000009:adverse effects*; D017131:Thrombectomy; D013997:Time Factors; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex