Abstract
In recent years, arterial closure devices have been developed and are now used after catheter intervention. These devices may however induce complications, such as infections and pseudoaneurysms. We report two cases with an infected femoral pseudoaneurysm caused by an arterial closure device (ACD). Case 1, an 83-year-old man, underwent percutaneous coronary intervention (PCI) and arterial puncture closing devices were used. Erythema and swelling appeared at the puncture lesion. He was diagnosed as having an infected pseudoaneurysm by echography and was referred to our hospital. The infection was extensive, and the vessel wall had been destroyed, making it difficult to perform treatment using a vein patch. We thus performed debridement of the infected site, and ilio-femoral bypass using a saphenous vein graft away from the infected lesion. The postoperative course was uneventful. Case 2 was a 60-year-old man with a history of diabetes mellitus and polio. An ACD was used for hemostasis after PCI in a previous hospital. An infectious response was observed at the puncture site. He received antibiotic therapy, but showed no improvement. He was therefore referred to our hospital. Because the infection was more extensive than in Case 1, we chose ilio-femoral bypass using expanded polytetrafluoroethylene in the retroperitoneal space in order to obtain a long root graft. The infected area was debrided and the wound was left open to allow washing irrigation during the postoperative course. Wound healing was prolonged, but he was ultimately discharged in good condition. We conclude that debridement and bypass surgery are satisfactory treatment methods for infected pseudoaneurysms caused by ACD.
