Korean J Radiol.  2013 Aug;14(4):636-639. 10.3348/kjr.2013.14.4.636.

Fluoroscopic Guided Fogarty Embolectomy for an Angio-Seal Embolism in the Popliteal Artery

• Hong D
• Lee SH
• Chung HH
• Seo BK
• Cha SH
• Lee KY
• Ahn JC

• KMID: 1715768
• DOI: http://doi.org/10.3348/kjr.2013.14.4.636

Abstract

The Angio-Seal is a widely used arterial closure device that helps achieve faster hemostasis and provide early ambulation to patients. However, it can cause various complications in clinical practice. We present the uncommon complication of popliteal artery occlusion following Angio-Seal deployment, and describe an effective interventional approach to its treatment. Because fluoroscopy-guided Fogarty embolectomy has the advantages of complete removal of the embolus without fragmentation, and clear visualization of the exact location of the embolus during the procedure, it is a suitable method for treating this complication.

Keyword

Angio-Seal; Complication; Popliteal artery; Embolism; Interventional therapy

MeSH Terms

Embolectomy/*instrumentation
Embolism/radiography/*surgery
Equipment Design
Fluoroscopy/*methods
Follow-Up Studies
Humans
Male
Middle Aged
*Popliteal Artery
Surgery, Computer-Assisted/*methods

Figure

• 

  Fig. 1 US and gross finding of Angio-Seal embolism and angiographic finding of embolectomy procedure using Forgaty catheter. A. In ultrasound, Angio-Seal is seen as well-defined round hyperechoic mass with more echogenic anchor (arrow) in right distal popliteal artery. Acute thrombus (arrowhead) is also noted proximal to Angio-Seal embolus. B. In right lower extremity angiography, total occlusion (arrow) of distal popliteal artery is noted. Arteries distal to occlusion are reconstituted through collateral circulation. C. 4 Fr Fogarty balloon catheter was advanced to distal portion of occlusion. Balloon was inflated and dragged proximally toward cutdown site of femoral artery. D. While pulling back balloon, some contrast was injected through sheath. Filling defect between balloon and contrast (arrow) indicated exact location of embolus. E. Material successfully removed by fluoroscopy-guided Fogarty embolectomy. Angio-Seal collagen plug (asterisk) and flat anchor (arrow) with thrombus (arrowhead) are noted.

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