Complications associated with the arterial puncture closure device--Angio-Seal.
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.
Kadner
Alexander
A
Swiss Cardiovascular Center, University Hospital, Freiburgerstrasse, Bern, Switzerland. alexander.kadner@insel.ch
Schmidli
Jürg
J
Schwegler
Igor
I
Dick
Florian
F
Schönhoff
Florian
F
Carrel
Thierry
T
Savolainen
Hannu
H
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