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An unusual cause of claudication
James A Shaw1, Edwin C Gravereaux, Gayle L Winters
1Cardiovascular Division, Interventional Cardiovascular Medicine, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA.
Summary
A rare complication occurred when an AngioSeal device anchor embolized 3 months after coronary angiography, causing claudication. The embolized anchor required retrieval and surgical removal.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Medical Device Complications
Background:
- Femoral arterial puncture is a common access route for coronary angiography.
- Vascular closure devices, such as AngioSeal, are frequently used to manage puncture sites.
- Complications, though rare, can arise from these closure devices.
Observation:
- A patient developed claudication symptoms three months post-coronary angiography.
- The angiography procedure involved closure of the femoral artery puncture site with an AngioSeal device.
- The claudication was linked to an embolized component of the AngioSeal device.
Findings:
- The AngioSeal anchor embolized distally, causing a lesion.
- Percutaneous revascularization was attempted but complicated by the embolized anchor.
- The anchor was successfully snared and retrieved to the femoral artery sheath.
- Surgical removal of the retrieved anchor was necessary.
Implications:
- This case highlights a delayed complication associated with AngioSeal closure devices.
- Embolization of closure device components can lead to significant vascular events.
- Careful monitoring and consideration of device integrity are crucial in managing vascular access complications.