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Percutaneous endovascular management of Angio-Seal related vascular occlusion

Dan Haberman1, Evan Czulada2, Lior Lupu1

  • 1Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|October 28, 2024
PubMed

Insights

Peripheral endovascular intervention effectively manages femoral artery occlusion caused by Angio-Seal vascular closure devices. This approach, primarily using directional atherectomy, achieved 100% success without complications, ensuring excellent long-term outcomes.

Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Endovascular Interventions

Background:

  • Vascular closure devices (VCDs) are standard for femoral arterial access hemostasis.
  • Complications like bleeding and femoral artery occlusion can necessitate vascular intervention.
  • Angio-Seal VCD deployment is associated with occlusive complications.

Purpose of the Study:

  • To detail a peripheral percutaneous endovascular interventional (PEI) approach for managing femoral artery occlusion.
  • To evaluate the efficacy and safety of PEI in patients with Angio-Seal VCD-related complications.

Main Methods:

  • Retrospective analysis of 40 patients with Angio-Seal occlusive complications (July 2013-September 2023).
  • All patients underwent PEI, with directional atherectomy as the primary technique.
  • Data analyzed included patient characteristics, procedural details, and short- to long-term follow-up.

Main Results:

  • 100% procedural success rate for PEI in all 40 patients.
  • Directional atherectomy used in 88%, balloon angioplasty in 13%, and stenting in 18%.
  • No procedural complications or surgical conversions; no re-interventions needed during median follow-up of 244 days.

Conclusions:

  • PEI, particularly with directional atherectomy and balloon angioplasty, is a safe and effective treatment for Angio-Seal VCD-related femoral artery occlusion.
  • This approach re-establishes flow with excellent long-term outcomes.
  • PEI offers a successful alternative to surgery for managing these specific VCD complications.
Abstract

Keywords:
Angio‐Sealatherectomyfemoral artery occlusionpercutaneous endovascular interventionvascular closure device

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