The patient was a 64-year old woman. She underwent right total knee arthroplasty at previous hospital, and had a significant hemorrhage from popliteal artery on the next day of the operation. So, she was taken to our hospital on the midnight of the day. We were consulted by ER doctor about uncontrollable hemorrhage the next morning. We performed emergency endovascular surgery with VIABAHN stent-graft (W. L. Gore, Flagstaff, Ariz, USA) and got hemostasis. The stent-graft remain patent for 2 years after the procedure.

Vascular complications associated with vascular closure devices (VCDs) rarely require emergency surgery. An 82-year-old man underwent percutaneous carotid artery stenting for internal carotid artery stenosis using the left common femoral artery as the access site. An Angio-Seal VCD was used for achieving hemostasis at the puncture site but was unsuccessful; therefore, manual compression was performed. On postoperative day 1, the patient developed numbness and paresthesia in the left lower extremity. Angiography and contrast computed tomography showed occlusion of the left common femoral artery, and emergency surgery was performed. Here, we discuss our understanding of this observation.