Clin Res Cardiol 96: Suppl 1 (2007)

P507 - Percutaneous transluminal recanalization of inadvertent occlusion of the common femoral artery caused by subcutaneous collagen application for puncture site closure after coronary angioplasty (Angio-Seal™deployment)
M. Brück1, D. Bandorski1, K. Rauber2, W. Kramer1
1Medizinische Klinik I, Klinikum Wetzlar, Wetzlar; 2Institut für Diagnostische und Interventionelle Radiologie, Klinikum Wetzlar, Wetzlar;
Background: The use of access site closure devices in interventional cardiology has expanded rapidly in the past several years. Initial reports indicated remarkable safety with these devices but there are a small number of major complications. This retrospective study was carried out to investigate the efficacy of percutaneous transluminal angioplasty (PTA) of inadvertent arterial occlusions after deployment of the Angio-Seal™device using a biodegradable anchor and collagen plug for sealing of arterial puncture sites.
Methods: From April 1996 to December 2005 a total of 3994 Angio-Seal™devices were deployed immediately after percutaneous coronary interventions. Within 48 hours after collagen application, clinical signs of an acute arterial occlusion were evident in 4 patients (0,1 %). They were immediately referred to a diagnostic angiography and subsequent PTA.
Results: Angiography revealed occlusion of the right common femoral artery at puncture site level. In each case, the collagen plug was found to be dislocated intraarterially. Using a cross-over access from the non-occluded femoral artery a PTA of the closed femoral artery was feasible in all cases. Low molecular weight heparin was administered for 72 hours. At routine follow-up 12 months thereafter, there was no clinical evidence of restenosis.
Conclusion: Inadvertent arterial occlusion at the arterial puncture site after Angio-Seal™closure device deployment is a rare but severe complication. PTA seems to be a safe and effective method of treatment, avoiding surgical removal of the plug.