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Symptoms And Treatment Of Vascular Closure

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Background

Vascular closure devices following cardiac catherization through the femoral artery have been gaining significant traction since its use in the mid-1990s. Compared to the previous gold standard of manual compression, VCDs allow for shortened time to ambulation, decreased duration of hospitalization post procedure, and increased patient comfort. The devices have also shown safeness comparable to manual compression. Despite the many advantages and variety of devices available, there are still complications to take into account. More common issues include device failure, bleeding, and hematoma. Less common but more serious complications include infection, ischemia, limb loss, and death.

Case Report
Our patient is a 74-year-old
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Due to these findings patient was directly admitted to the hospital and placed on a heparin drip. On physical exam patient had absent pulses below the right femoral artery. However, there was no discoloration, change of temperature, or sensory as well as motor deficits of the right lower extremity. Patient was taking a low-dose aspirin and red yeast rice for cholesterol management at that time.
The following morning the patient underwent successful angioplasty of the right common femoral artery with thrombectomy and a 6 x 20 mm balloon angioplasty, reducing a 90% stenosis to less than 30%. A spider catheter was deployed to perform the thrombectomy, however an atrial blazer catheter failed to retrieve the spider device as it was unable to completely collapse. As a result the patient was taken to the OR for vascular surgery. The spider basket was retrieved through the wall of the common femoral artery with its contents.
The specimen was sent to pathology, which noted a foreign body device surrounded by soft tissue attached to the spider device. The foreign body was noted to be a Angio-Seal plug from the left heart catheterization that had been presumed a thrombus.
Discussion
Promising results have shown that the Angio-seal VCD has excellent efficacy and safety after routine catheterization and intervention. However, clear indications of use and risk of complications need to be evaluated and monitored.

Advantages to using a closure
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