Abstract
Objective: We report two cases of Angio-Seal closure related infectious aneurysm of femoral artery which required surgical treatment.
Case presentation: Case 1. A 71-year-old male presented with transient unconsciousness due to right internal carotid artery (ICA) occulusion and left ICA severe stenosis. We performed percutaneous transcatheter angioplasty (PTA) with right groin puncture for left internal carotid stenosis. We used Angio-Seal for femoral artery closure. Bacterial cellulitis appeared at his right groin after PTA. On the 61st hospital day, we found an infectious aneurysm. He was performed the graft replacement of right common femoral artery for his infectious aneurysm on the 90th hospital day. Case 2. A 51-year-old female presented with subarachnoid hemorrhage due to ruptured left ICA-paraclinoid aneurysm. We performed coil embolization, and used Angio-Seal for right femoral artery closure. We found a hematoma at groin puncture site on the 6th hospital day, which was complicated with bacterial infection. An antibiotic was prescribed, her inflammatory reaction diminished with a blood test. But, we found an infected aneurysm on right groin by ultrasonography and 3D CT on the 21st hospital day. She was performed the graft replacement of right common femoral artery for her infected aneurysm on the 25th hospital day.
Conclusion: The Angio-Seal closure device is useful for decreased demand for health-care personnel to place manual pressure on the groin site, but it is a foreign matter, and so may be at risk of infection. Advancing in severity, an infected aneurysm may develop, which may need surgical treatment. To avoid this complication, it is important to keep the wound clean and the patient on bed rest, and in high risk cases of infection, manual pressure should be selected for hemostasis instead of percutaneous vascular closure devices.
