title: Initial experience with the AXERA 2 Femoral Access System in neurovascular procedures.
abstract: BACKGROUND
  Conventional cerebral angiography is a commonly performed procedure in medicine. Vascular closure devices have been developed as alternatives to manual compression at the arteriotomy site and prolonged bed rest. The risks of using these devices include arterial dissection, groin hematoma, and device failure. Herein, we describe our experience with the use of a novel device used for arterial access and closure, the AXERA 2 Access System.
  
  
  METHODS
  A total of 13 patients underwent vascular access and closure with the AXERA 2 Access System.
  
  
  RESULTS
  Arterial access using the AXERA 2 Access System was achieved in 11 of 13 patients. Amongst the patients with successful access, one patient experienced a groin hematoma requiring manual compression and two patients suffered occlusions of the common femoral artery due to dissections, with both patients requiring femoral artery thromboendarterectomies.
  
  
  CONCLUSIONS
  This small series highlights a heretofore underreported serious complication rate of the AXERA 2 Access System. Additional studies are warranted to provide further insight into risk factors for device failure and complication development.
authors.affiliation: Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors.forename: Ramesh
authors.initials: R
authors.lastname: Grandhi
authors.affiliation: Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors.forename: Nathan T
authors.initials: NT
authors.lastname: Zwagerman
authors.affiliation: University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
authors.forename: Xiaoran
authors.initials: X
authors.lastname: Zhang
authors.affiliation: University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
authors.forename: Stephanie H
authors.initials: SH
authors.lastname: Chen
authors.affiliation: UPMC Stroke Institute, Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors.forename: Ashutosh P
authors.initials: AP
authors.lastname: Jadhav
authors.affiliation: UPMC Stroke Institute, Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors.forename: Tudor
authors.initials: T
authors.lastname: Jovin
authors.affiliation: Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA jankbt@upmc.edu.
authors.forename: Brian T
authors.initials: BT
authors.lastname: Jankowitz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002533:Cerebral Angiography; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000628:therapy; D065506:Vascular Closure Devices; D014656:Vascular Surgical Procedures / Q000295:instrumentation*
keywords: Angiography; complication; vascular closure devices