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Angio-seal in antegrade endovascular interventions: technical success and complications in a 55-patient series
Baljendra Kapoor1, Anukul Panu, Bruce Berscheid
1Vascular and Interventional Radiology, The University of Alabama at Birmingham, Birmingham, Alabama 35249, USA. bkapoor@uabmc.edu
Insights
The Angio-Seal device demonstrated high technical success (98.2%) for hemostasis in antegrade common femoral artery (CFA) punctures, with a low complication rate. This suggests Angio-Seal is safe and effective for CFA access.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Medical Devices
Background:
- Vascular closure devices (VCDs) are increasingly used for arterial access.
- Hemostasis in antegrade common femoral artery (CFA) punctures is crucial for patient safety.
- Evaluating the efficacy and safety of specific VCDs like Angio-Seal is important.
Purpose of the Study:
- To evaluate the technical success rate of the Angio-Seal device.
- To assess the incidence of complications associated with Angio-Seal use.
- To determine the safety and effectiveness of Angio-Seal in antegrade CFA punctures.
Main Methods:
- Retrospective review of clinical data and angiograms from 55 patients.
- Analysis of 56 antegrade CFA punctures using Angio-Seal devices (6-F and 8-F).
- Assessment of technical success and complication rates.
Main Results:
- High technical success rate of 98.2% (55/56 punctures).
- Low complication rate: two small hematomas (3.6%) and one device/operator failure.
- No instances of pseudoaneurysm, arterial injury, or large hematomas requiring transfusion.
Conclusions:
- Angio-Seal appears to be a safe and effective device for achieving hemostasis in antegrade CFA punctures.
- Further randomized trials are needed to compare Angio-Seal with manual compression.
- The findings support the use of Angio-Seal in this patient population.
Purpose:
To assess the technical success and complications of Angio-Seal vascular closure device in antegrade common femoral artery (CFA) punctures.
Methods:
Over a 14-month period, 55 patients (37 men; age range 37-94 years) underwent antegrade CFA Angio-Seal placement at a single center; the clinical data and angiograms were reviewed retrospectively. A total of 56 antegrade CFA punctures were made for hemostasis; 6-F Angio-Seal devices (40 model STS and 12 model VIP) were deployed in 52 CFAs, and 8-F Angio-Seal devices were deployed in 4.
Results:
The technical success rate was 98.2% (55/56). Two (3.6%) patients developed small, non-expanding hematomas (<5 cm) during deployment of the device. There was 1 episode of device/operator failure, presumably due to extravascular deployment within soft tissue. None of the patients developed pseudoaneurysm, arterial injury, or large hematomas requiring transfusion. Small calcified plaques at the puncture site did not influence the outcome.
Conclusion:
This series suggests that Angio-Seal may be a safe and effective device for hemostasis in antegrade CFA punctures. Further randomized trials testing its risk-benefit balance in comparison to standard manual compression are warranted.
