The Case of a Patient with Femoral Artery Stenosis Caused by Angio-Seal® Use Treated with Endoarterectomy
10.4326/jjcvs.45.62
- VernacularTitle:Angio-Seal® に起因した大腿動脈狭窄性病変に対して血栓内膜摘除術を施行した1例
- Author:
Masakazu Kawasaki
;
Yoshimitsu Ishibashi
;
Kiyotaka Morimoto
;
Hideyuki Kunishige
;
Nozomu Inoue
- Publication Type:Journal Article
- Keywords:
embolization of basilar artery aneurysm;
Angio-Seal®;
endoarterectomy
- From:Japanese Journal of Cardiovascular Surgery
2016;45(1):62-66
- CountryJapan
- Language:Japanese
-
Abstract:
In cases of hemostasis of the femoral artery where the sheath is removed after percutaneous catheterization, there is greater improvement in patient condition and shorter duration of hospital stay when arterial puncture closing devices are used rather than standard manual compression because the use of these devices results in shorter hemostasis and rest times. However, some complications due to these devices have also been reported. Here, we report a case of femoral artery stenosis due to Angio-Seal® use in a 67-year-old woman. Embolization of the basilar artery aneurysm by endovascular treatment was performed at another institution ; the percutaneous puncture site was the right femoral artery. When this treatment was provided, hemostasis of the artery was performed with the Angio-Seal®. About one month after the embolization, right intermittent claudication occurred after a 300-m walk. Echography and computed tomography (CT) angiogram showed 75% stenosis of the right common femoral artery, and therefore endoarterectomy of the artery was performed. The postoperative course was favorable and the ankle brachial index score improved from 0.82 to 1.15. In addition, CT angiogram showed resolution of the stenosis of the right common femoral artery and right intermittent claudication ameliorated. Based on the intraoperative views, it was suggested that the arteriosclerotic lesion had existed at the common femoral artery before the endovascular treatment and it might be the cause of the complication mentioned above. In order to prevent complications due to Angio-Seal® use, it is important to examine the indications of the use of this device by evaluating the puncture site of the artery with echography and other diagnostic techniques before the insertion of a sheath.
