Delayed complication from a percutaneous vascular closure device following a neuro-interventional procedure

Ahmad Khaldi, Ben Waldau, C. Skowlund, G. J. Velat, J. Mocco, B. L. Hoh

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Percutaneous vascular closure devices are being increasingly used as alternatives to manual compression for the closure of femoral arteriotomy after endovascular procedures as they appear to reduce time to ambulate, improve patient's comfort, and are implicated with cost saving. However, vascular closure devices have been associated with an increased risk of complications including hematoma formation, local bleeding, arteriovenous fistula formation, pseudoaneurysm and arterial leg ischemia. To our knowledge, if the above complications occur it is usually within the first 30 days after the procedure. None have been reported in a delayed fashion ten months or longer after closure. We describe a 30-year-old man with a history of a giant basilar trunk aneurysm. He was placed on aspirin and clopidogrel prior to the procedure. He had bilateral femoral access with 6 French sheaths. Following the procedure, 6 French Angio-Seals (St. Jude Medical, St. Paul, MN, USA) were used for closure of bilateral femoral arteriotomies. Ten months after the procedure, the patient kicked a metal cart and developed a large right retroperitoneal iliopsoas hematoma. There was no evidence of pseudoaneurysm. The patient was managed conservatively and his serial hematocrit stayed stable. He did not require surgical intervention. Use of percutaneous vascular closure devices is associated with complications including risk of hematoma, pseudoaneurysm, intravenous fistula, rectal peritoneal hemorrhage, limb ischemia and possible surgical repair. Most complications occur peri-procedure or within 30 days post-procedure. This is the first reported case of a delayed complication at ten months after the initial procedure. Site-related complications associated with percutaneous vascular closure devices may occur in a delayed fashion, even ten months post-procedure, so should be considered in the management of patients.

Original languageEnglish (US)
Pages (from-to)495-500
Number of pages6
JournalInterventional Neuroradiology
Volume17
Issue number4
StatePublished - Dec 2011
Externally publishedYes

Fingerprint

False Aneurysm
Thigh
Hematoma
clopidogrel
Ischemia
Rectal Fistula
Hemorrhage
Endovascular Procedures
Vascular Closure Devices
Arteriovenous Fistula
Hematocrit
Aspirin
Aneurysm
Leg
Extremities
Metals
Costs and Cost Analysis

Keywords

  • Retroperitoneal hematoma
  • Vascular closure device

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

Cite this

Delayed complication from a percutaneous vascular closure device following a neuro-interventional procedure. / Khaldi, Ahmad; Waldau, Ben; Skowlund, C.; Velat, G. J.; Mocco, J.; Hoh, B. L.

In: Interventional Neuroradiology, Vol. 17, No. 4, 12.2011, p. 495-500.

Research output: Contribution to journalArticle

Khaldi, Ahmad ; Waldau, Ben ; Skowlund, C. ; Velat, G. J. ; Mocco, J. ; Hoh, B. L. / Delayed complication from a percutaneous vascular closure device following a neuro-interventional procedure. In: Interventional Neuroradiology. 2011 ; Vol. 17, No. 4. pp. 495-500.
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