title: Feasibility of vascular access closure in arteries other than the common femoral artery using the ExoSeal vascular closure device.
abstract: OBJECTIVE
  To describe the feasibility of vascular access closure in arteries other than the common femoral artery (CFA) using the ExoSeal vascular closure device (VCD).
  
  
  METHODS
  Between December 2011 and August 2013, 8 patients (4 males, 4 females, mean age 64 years [range 42-81]) underwent 13 extrafemoral access site closure using the ExoSeal VCD (brachial artery n = 7, venous femoropopliteal bypass n = 3, femoropopliteal segment n = 2, proximal superficial femoral artery n = 1). Patient history, procedural characteristics, and complications were recorded.
  
  
  RESULTS
  Technical success was achieved in 12 of 13 VCD procedures. In 1 case of brachial puncture, safe plug-deployment was not possible, so manual compression was applied. In this case, angiographic and clinical control showed residual bleeding 5 min after the procedure. After additional manual compression for 5 min, the haemorrhage stopped, but a hematoma <3 cm was detectable (procedural success rate 12 of 13 closures). Overall no major complications were observed. Heparin, 5,000 IU, was administered in all cases. Six ExoSeal closures were performed under additional acetylsalicylic acid (ASS) and clopidogrel, three under additional ASS, and the remaining four under heparin only. International normalized ratio and thrombocytes were within normal values in all patients.
  
  
  CONCLUSIONS
  Successful vascular access closure using the ExoSeal VCD in puncture sites other than the CFA is feasible with a low complication rate. These applications, however, remain an "off-label" use in selected patients.
authors: Department of Radiology, University of Bonn, Sigmund-Freud-Str. 25, 53129, Bonn, Germany, claus.christian.pieper@ukb.uni-bonn.de.
authors: Claus Christian
authors: CC
authors: Pieper
authors: Kai E
authors: KE
authors: Wilhelm
authors: Hans Heinz
authors: HH
authors: Schild
authors: Carsten
authors: C
authors: Meyer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001916:Brachial Artery / Q000000981:diagnostic imaging*; D005240:Feasibility Studies; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery / Q000000981:diagnostic imaging*; D011859:Radiography; D016896:Treatment Outcome; D065506:Vascular Closure Devices / Q000706:statistics & numerical data*