Related Experiment Videos
Complications associated with percutaneous closure devices
M D Gonze1, W C Sternbergh, K Salartash
1Department of Surgery, Ochsner Medical Institutions, New Orleans, Louisiana 70121, USA.
Insights
Vascular closure devices used after angiography can lead to complications such as abscesses, pseudaneurysms, ischemia, and bleeding, necessitating surgical intervention in many cases.
Area of Science:
- Cardiovascular Medicine
- Interventional Radiology
- Surgical Complications
Background:
- Angiography necessitates effective hemostasis.
- Vascular closure devices aim to reduce closure time.
- Complications associated with these devices require reporting.
Purpose of the Study:
- To report complications associated with vascular closure devices.
- To analyze the types and incidence of adverse events.
Main Methods:
- Retrospective review of 2,181 procedures.
- Analysis of closure device use in 408 patients (19%).
- Detailed review of specific closure devices: Angio-Seal, ProstarXL, and Duett.
Main Results:
- A 2.5% complication rate (10 of 408 patients).
- Complications included subcutaneous abscesses, pseudaneurysms, lower extremity ischemia, and acute bleeding.
- Most complications required surgical management; one retroperitoneal bleed was managed nonoperatively.
Conclusions:
- Complications from vascular closure devices are a significant concern.
- Increased use of these devices is likely to lead to more frequent complications.
- Awareness and vigilance are crucial for managing these adverse events.
Background:
In an effort to reduce time to hemostasis after angiography, several closure devices have been marketed. We report some of their complications.
Methods:
A retrospective review was conducted.
Results:
Over an 8-month study period, 2,181 diagnostic and interventional procedures were performed. Closure devices were used in 408 (19%) of these patients. The Angio-Seal closure device is composed of a collagen sponge and an absorbable polymer anchor that compresses the hole in the arteriotomy. The ProstarXL sealing device consists of a rotating barrel that deploys 4 needles through the arteriotomy, and then individual knots are extracorporeally tied. The Duett device consists of a balloon occluding catheter and injectable collagen and thrombin. Ten of the patients developed a complication from the closure device (2.5%). Four of these were subcutaneous abscesses. Two of these patients had expanding pseudaneurysms, 2 had lower extremity ischemia, and 1 patient had an acute bleed. These complications were all managed surgically. Another patient developed a retroperitoneal bleed that was managed nonoperatively.
Conclusions:
As the use of these devices increase, these complications will become more common.