Use of the 8-F angio-seal vascular closure device in large-caliber arteriotomies.
OBJECTIVE
To evaluate the feasibility and safety of using the 8-F Angio-Seal vascular closure device (VCD) to seal large-caliber (>8-F) access sites during percutaneous endovascular interventions.


METHODS
A retrospective review was undertaken of 42 consecutive patients (34 men; mean age 67.8 years, range 36-94) undergoing percutaneous peripheral interventions with sheaths ranging from 9-F to 12-F and subsequent closure using 8-F Angio-Seal VCDs. Single-wall puncture (n = 48) of the common femoral artery was guided by ultrasound in 46 cases and palpation in 2. Forty procedures required therapeutic heparinization during the interventional procedure; protamine was administered in only 5. Per protocol, manual pressure was held for 15 minutes. Clinical and/or imaging follow-up was available in all cases within 3 months after the procedure.


RESULTS
Immediate technical success was achieved in all cases, with hemostasis obtained within 5 minutes (no oozing or hematoma). The overall complication rate was 4.1% (2/48); one hematoma requiring surgical repair occurred 10 hours after VCD deployment. An asymptomatic pseudoaneurysm was discovered on follow-up imaging and was treated with ultrasound-guided thrombin injection with complete resolution.


CONCLUSIONS
The use of the 8-F Angio-Seal VCD to close large-caliber arteriotomies ranging from 9-F to 12-F is feasible and safe, with a low complication rate.
Section of Interventional Radiology, The George Washington University Hospital, Washington, DC, USA. ssarin@gwu.edu
Shawn N
SN
Sarin
Raj K
RK
Shah
Albert
A
Chun
Andrew
A
Akman
Subodh
S
Arora
Rodeen
R
Rahbar
Richard
R
Neville
Anthony C
AC
Venbrux
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004219:District of Columbia; D057510:Endovascular Procedures / Q000009:adverse effects; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D005263:Femoral Artery; D006470:Hemorrhage / Q000209:etiology / Q000517:prevention & control*; D006489:Hemostatic Techniques / Q000009:adverse effects / Q000295:instrumentation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011312:Pressure; D011677:Punctures; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome