A Successful Case of Embolectomy for Acute Popliteal Artery Occlusion Caused by a Synthetic, Bioabsorbable Plug of EXSOSEAL

Abstract

EXOSEAL, a vascular closure device, is a passive approximator that deploys a synthetic, bioabsorbable polyglycolic acid (PGA) plug to the extravascular space just adjacent to the arteriotomy site. We experienced a case of embolectomy for acute right popliteal artery occlusion caused by the PGA plug. An 84-year-old female had percutaneous endovasucular treatment for left superficial femoral arterial stenosis through right femoral artery. After the treatment, EXOSEAL was used for the puncture site in right groin. Soon after she went back to the ward, she complained discomfort in her right limb. As the time went by, the complaint changed to severe pain. After the examination, we made a daiagnosis of acute right popliteal arterial occlusion. We emergently exposed her right common femoral artery, and succeeded embolectomy using Fogarty catheter. She comes to our hospital regularly without sequelae 1 year after the treatment. The event found in this case was rare, but a specific complication after the use of EXOSEAL. Understanding of structure as well as mechanism of the vascular device including EXOSEAL is crucial for those involved in endovascular treatment in unexpected situations.