title: Treatment of Angio-Seal-Related Femoral Artery Occlusion Using Directional Atherectomy-Primary Results and Midterm Follow-Up.
abstract: OBJECTIVE
  We describe a novel approach for the endovascular treatment of femoral artery occlusion as a result of Angio-Seal closure device deployment.
  
  
  BACKGROUND
  Angio-Seal is the most commonly used vascular closure device following percutaneous coronary and peripheral catheterizations worldwide. A rare complication of Angio-Seal deployment is an occlusion of the femoral artery leading to limb ischemia requiring revascularization. Given its unique ability to cut both atherosclerotic plaque and the Angio-Seal anchor with a collagen plug at operator-directed planes, TurboHawk/HawkOne atherectomy device can be a fast and effective approach to treat Angio-Seal-associated femoral artery occlusions.
  
  
  METHODS
  We studied 13 consecutive patients who developed Angio-Seal-associated femoral artery occlusions that occurred from 3 hours to several weeks after catheterization. These patients were successfully treated with TurboHawk/HawkOne directional atherectomy followed by balloon angioplasty with no complications. During a mean follow-up period of 20.4 ± 17.3 months, 12 patients remained claudication free with no evidence of obstructive arterial disease of the treated segment on imaging studies. One patient developed restenosis that was treated with repeat atherectomy and balloon angioplasty following which he was asymptomatic at follow-up.
  
  
  CONCLUSIONS
  The use of directional atherectomy followed by balloon angioplasty is a quick, safe, and effective endovascular approach to treating Angio-Seal-associated femoral artery occlusions. It is associated with an excellent success rate, no complications, and good midterm outcomes.
authors.affiliation: 1 Division of Cardiology, Department of Medicine, New York University, NY, USA.
authors.forename: Anvar
authors.initials: A
authors.lastname: Babaev
authors.affiliation: 1 Division of Cardiology, Department of Medicine, New York University, NY, USA.
authors.forename: Rohit
authors.initials: R
authors.lastname: Gokhale
authors.affiliation: 1 Division of Cardiology, Department of Medicine, New York University, NY, USA.
authors.forename: Susanna
authors.initials: S
authors.lastname: Zavlunova
authors.affiliation: 1 Division of Cardiology, Department of Medicine, New York University, NY, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Attubato
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D017073:Atherectomy / Q000009:adverse effects / Q000379:methods*; D002406:Catheterization, Peripheral / Q000009:adverse effects; D003251:Constriction, Pathologic; D016208:Databases, Factual; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D006470:Hemorrhage / Q000209:etiology / Q000517:prevention & control*; D006489:Hemostatic Techniques / Q000009:adverse effects* / Q000295:instrumentation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011677:Punctures; D012008:Recurrence; D013997:Time Factors; D016896:Treatment Outcome; D065506:Vascular Closure Devices / Q000009:adverse effects*; D014654:Vascular Patency
keywords: Angio-Seal; directional atherectomy; femoral artery obstruction