Angioscopic Observation of Acute Femoral Artery Occlusion Complicated by Use of Angio-seal Vascular Closure Device

抄録

Femoral arteries are the most popular vessels of vascular access for angiography or percutaneous catheter intervention because of their diameter and accessibility. After the catheter procedures, hemostasis at the puncture site is achieved with conventional manual compression or by use of several vascular closure devices (VCDs) in recent years. However, the use of these devices infrequently results in lower limb ischemia as their major complications. We highlight a case of acute femoral artery occlusion caused by Angio-Seal ™ hemostatic device and angioscopic findings of the case. Angioscopy after revascularization by balloon angioplasty revealed a residual red and white thrombi and an inorganic pale mass protruding into the lumen. The color of the mass was considered strange in vivo. On the basis of angioscopic findings, it was speculated that collagen sponge of the Angio-Seal accidently penetrated in to the arterial wall and the collagen component in the lumen caused thrombotic occlusion. Interventional cardiologist should be aware that serious problems sometimes occur when VCDs are used.