J Cerebrovasc Endovasc Neurosurg.  2014 Sep;16(3):275-280. 10.7461/jcen.2014.16.3.275.

Delayed Vascular Claudication Following Diagnostic Cerebral Angiography: A Rare Complication of the AngioSeal Arteriotomy Closure Device

• Corley JA
• Kasliwal M
• Tan LA
• Lopes DK

• KMID: 1963167
• DOI: http://doi.org/10.7461/jcen.2014.16.3.275

Abstract

With rapidly increasing numbers of neuroendovascular procedures performed annually in recent years, use of arterial closure devices after femoral artery access has been exceedingly common secondary to reduced time to hemostasis, decreased patient discomfort, earlier mobilization, and shortened hospital stay. Although uncommon, use of these devices can lead to a different spectrum of complications, as compared to manual compression. Ischemic symptoms following the use of these devices can have unexpected clinical sequelae and can occur in a delayed fashion. Awareness and recognition of such complications is important with the dramatically increased use of these devices in recent years. We report on a case of delayed vascular complication manifesting as vascular claudication following use of the AngioSeal closure device.

Keyword

AngioSeal; Cerebral angiography; Closure device; Complication; Manual compression; Vascular

MeSH Terms

Cerebral Angiography*
Femoral Artery
Hemostasis
Humans
Length of Stay

Figure

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  Fig. 1 Axial T1 and T2 weighted Magnetic resonance imaging (MRI) of the brain showing the presence of flow voids in the left parietal lobe suggestive of a vascular malformation.

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  Fig. 2 Lateral and AP views of the left internal carotid artery injection during cerebral angiography showing a superficial left parietotemporal arteriovenous malformation (AVM) measuring 15.3×10.3 mm in size.

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  Fig. 3 Axial image of the computed tomography angiography (CTA) (left) and duplex ultrasound (right) of the right femoral artery demonstrating a partially occlusive thrombus in the right common femoral artery.

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  Fig. 4 Explanted AngioSeal device during surgery.

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  Fig. 5 Femoral Angiogram showing that the puncture site is very close to the bifurcation.

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