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Management of acute lower limb ischemia associated with the Angio-Seal arterial puncture closing device

Andrea Siani1, Federico Accrocca, Roberto Gabrielli

  • 1Vascular and Endovascular Surgery Unit, ASL RMF 'San Paolo' Hospital, Largo Donatori di Sangue, Civitavecchia, 00053 Rome, Italy.

Interactive Cardiovascular and Thoracic Surgery
|December 22, 2010
PubMed

Insights

Arterial percutaneous closure devices can cause acute lower limb ischemia. Careful patient selection is advised to minimize risks and the need for complex surgical repair.

Area of Science:

  • Vascular Surgery
  • Interventional Cardiology

Background:

  • Arterial percutaneous closure devices (APCD) are widely used.
  • APCD can lead to severe vascular complications, including acute lower limb ischemia.

Purpose of the Study:

  • To retrospectively evaluate acute lower limb ischemia following APCD use.
  • To identify risk factors associated with ischemic complications from APCD.

Main Methods:

  • Retrospective analysis of 198 patients who received Angio-Seal devices (2004-2009).
  • Comparison of patients with complications (Group A) versus those without (Group B) using Student's t-test.
  • 36-month follow-up with color-coded duplex ultrasound.

Main Results:

  • Eight patients (4%) experienced acute lower limb ischemia requiring urgent surgical repair.
  • Limb salvage rate was 87.5%.
  • Significant risk factors included diabetes, obesity, severe femoral atherosclerosis, sheath size >7 Fr, and prolonged procedures.

Conclusions:

  • Vascular injuries from APCD, though uncommon, often necessitate complex surgical repair.
  • Improved patient selection is crucial for reducing APCD-related ischemic complications.

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