title: Percutaneous transluminal angioplasty of suture-mediated closure device-related femoral artery stenosis or occlusive disease.
abstract: This study evaluates the efficacy of percutaneous transluminal balloon angioplasty (PTA) to treat stenosis or occlusion following haemostasis using a suture-mediated closure (SMC) device. Steno-occlusion occurred in 7 (0.4%) patients, some with claudication, others without. Steno-occlusion was diagnosed immediately after haemostasis in the four patients without claudication, but diagnosis was delayed in all three patients with claudication. Six of the patients subsequently underwent PTA using a contralateral femoral arterial approach. Technical success, clinical response and vessel patency were evaluated retrospectively. Follow-up angiography revealed focal segmental steno-occlusion (<1 cm) in the common femoral or proximal superficial femoral artery in four patients and long segmental occlusion (>1 cm) in the external iliac and common femoral arteries in three patients. PTA was technically successful in all patients (6/6, 100%). Among the three patients who developed delayed onset of claudication, one declined treatment and the claudication improved in two. Doppler ultrasound obtained 28-129 days (mean; 75 days) after PTA revealed patent arterial flow in six patients. One patient with delayed-onset occlusion refused the procedure because the symptoms were mild. This study has shown that PTA is a useful treatment for steno-occlusion following haemostasis using the SMC device. Careful angiography and review of the femoral bifurcation prior to use of an SMC device is important.
authors.affiliation: Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Y-J
authors.initials: YJ
authors.lastname: Kim
authors.forename: H-K
authors.initials: HK
authors.lastname: Yoon
authors.forename: G-Y
authors.initials: GY
authors.lastname: Ko
authors.forename: J-H
authors.initials: JH
authors.lastname: Shin
authors.forename: K-B
authors.initials: KB
authors.lastname: Sung
mesh_terms: D000328:Adult; D000368:Aged; D000792:Angiography; D000800:Angioplasty, Balloon; D001157:Arterial Occlusive Diseases / Q000209:etiology / Q000628:therapy*; D003251:Constriction, Pathologic / Q000209:etiology / Q000628:therapy; D005260:Female; D005263:Femoral Artery; D006488:Hemostasis, Surgical / Q000009:adverse effects*; D006801:Humans; D007383:Intermittent Claudication / Q000209:etiology; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D010292:Paresthesia / Q000209:etiology; D013536:Suture Techniques / Q000009:adverse effects*