BACKGROUND Complications of vascular closure devices mainly include bleeding,vascular injury,and trapped device that cannot be removed percutaneously.However,arterial stenosis or occlusion induced by vascular injury i...BACKGROUND Complications of vascular closure devices mainly include bleeding,vascular injury,and trapped device that cannot be removed percutaneously.However,arterial stenosis or occlusion induced by vascular injury is rare.This article introduces a rare case with severe acute limb ischemia after using the vascular closure device(StarClose).CASE SUMMARY A 54-year-old man was admitted because of necrosis of the second toe of the left foot for 2 mo.Ultrasound showed left femoral artery stenosis,and occlusion of the left popliteal,posterior tibial,peroneal,anterior tibial and dorsalis pedis arteries,suggesting arteriosclerosis obliterans of low extremities,gangrene and type 2 diabetes.He underwent an interventional procedure of drug-eluting balloon in the left lower limb via antegrade puncture of the left common femoral artery.He developed acute limb ischemia after 1 h,and severe pain,numbness,pale skin,low skin temperature and weakened sensation in the left foot.Injury of the common femoral artery intima was considered.Exploratory surgery showed occlusion at the puncture point accompanied with bulged vascular lumen and flipped vascular intima caused by StarClose.The flipped intima was removed.The limb blood supply was restored and the limb was saved post-surgery.He recovered well at final follow-up.CONCLUSION Incorrect use of the vascular closure device was the main cause of severe acute limb ischemia in this case.展开更多
Inadvertent puncture of the subclavian artery is an uncommon but potentially fatal complication of the commonly performed internal jugular vein catheterization.We report a case of accidental subclavian artery catheter...Inadvertent puncture of the subclavian artery is an uncommon but potentially fatal complication of the commonly performed internal jugular vein catheterization.We report a case of accidental subclavian artery catheterization close to the vertebral artery during internal jugular venous cannulation,which was successfully managed in the interventional suite with catheter removal and use of a vascular closure device.展开更多
AIM To report 17-mo experience of femoral artery puncture site closure during angiographic procedures using Exo Seal vascular closure devices(VCDs).METHODS Between November 2015 and April 2017, we performed 179 diagno...AIM To report 17-mo experience of femoral artery puncture site closure during angiographic procedures using Exo Seal vascular closure devices(VCDs).METHODS Between November 2015 and April 2017, we performed 179 diagnostic and interventional angiographic procedures via a common femoral arterial access.The Exo Seal VCD was used at the puncture site to achieve hemostasis in 125 patients.We evaluated the technical and procedural success rates, the complications, and the factors affecting the hemostasis time of the ExoSeal VCDs.RESULTS Technical and procedural successes were achieved in 176 cases(98.0%) and 128 cases(71.5%), respectively.Device failure occurred in 3(1.7%) cases.In 1 case(0.6%) a small hematoma developed, but there were no major complications.Among the hemostasis-relevant variables, a history of drinking alcohol, low platelet(PLT) count, and high prothrombin time-international normalized ratio(commonly known as PT-INR) values were the statistically significant predictors of the need for longer manual compression(MC).There was no difference in the success rates between the repeat and single Exo Seal procedure groups, and repeated use of the ExoSeal did not affect hemostasis time.CONCLUSION The ExoSeal VCD effectively achieves hemostasis, with few complications.Longer light MC may be needed with alcohol drinkers, low PLT count, and high PT-INR values.展开更多
基金Supported by the Traditional Chinese Medicine Science,No.2017-057,2017-058 and 2019-0969Technology Development Project of Shandong Province,No.2019-0971
文摘BACKGROUND Complications of vascular closure devices mainly include bleeding,vascular injury,and trapped device that cannot be removed percutaneously.However,arterial stenosis or occlusion induced by vascular injury is rare.This article introduces a rare case with severe acute limb ischemia after using the vascular closure device(StarClose).CASE SUMMARY A 54-year-old man was admitted because of necrosis of the second toe of the left foot for 2 mo.Ultrasound showed left femoral artery stenosis,and occlusion of the left popliteal,posterior tibial,peroneal,anterior tibial and dorsalis pedis arteries,suggesting arteriosclerosis obliterans of low extremities,gangrene and type 2 diabetes.He underwent an interventional procedure of drug-eluting balloon in the left lower limb via antegrade puncture of the left common femoral artery.He developed acute limb ischemia after 1 h,and severe pain,numbness,pale skin,low skin temperature and weakened sensation in the left foot.Injury of the common femoral artery intima was considered.Exploratory surgery showed occlusion at the puncture point accompanied with bulged vascular lumen and flipped vascular intima caused by StarClose.The flipped intima was removed.The limb blood supply was restored and the limb was saved post-surgery.He recovered well at final follow-up.CONCLUSION Incorrect use of the vascular closure device was the main cause of severe acute limb ischemia in this case.
文摘Inadvertent puncture of the subclavian artery is an uncommon but potentially fatal complication of the commonly performed internal jugular vein catheterization.We report a case of accidental subclavian artery catheterization close to the vertebral artery during internal jugular venous cannulation,which was successfully managed in the interventional suite with catheter removal and use of a vascular closure device.
文摘AIM To report 17-mo experience of femoral artery puncture site closure during angiographic procedures using Exo Seal vascular closure devices(VCDs).METHODS Between November 2015 and April 2017, we performed 179 diagnostic and interventional angiographic procedures via a common femoral arterial access.The Exo Seal VCD was used at the puncture site to achieve hemostasis in 125 patients.We evaluated the technical and procedural success rates, the complications, and the factors affecting the hemostasis time of the ExoSeal VCDs.RESULTS Technical and procedural successes were achieved in 176 cases(98.0%) and 128 cases(71.5%), respectively.Device failure occurred in 3(1.7%) cases.In 1 case(0.6%) a small hematoma developed, but there were no major complications.Among the hemostasis-relevant variables, a history of drinking alcohol, low platelet(PLT) count, and high prothrombin time-international normalized ratio(commonly known as PT-INR) values were the statistically significant predictors of the need for longer manual compression(MC).There was no difference in the success rates between the repeat and single Exo Seal procedure groups, and repeated use of the ExoSeal did not affect hemostasis time.CONCLUSION The ExoSeal VCD effectively achieves hemostasis, with few complications.Longer light MC may be needed with alcohol drinkers, low PLT count, and high PT-INR values.
