Endovascular therapy for Angio-sealTM -related acute limb ischemia: Perioperative and long-term results

Catheter Cardiovasc Interv. 2017 Mar;89(S1):609-615. doi: 10.1002/ccd.26936. Epub 2017 Feb 13.

Abstract

Objectives: To investigate the perioperative and long-term outcomes of endovascular therapy for Angio-sealTM -related acute limb ischemia.

Background: Currently, limited data are available on the optimal treatment strategy for Angio-sealTM -related acute lower limb ischemia.

Methods: The prospectively maintained patient database of our institution was retrospectively searched to identify all patients who developed acute lower limb ischemia after use of the Angio-SealTM and received endovascular treatment from January 2010 to February 2016. The clinical and follow-up data were evaluated.

Results: Thirty-two patients with Angio-SealTM -related acute limb ischemia underwent endovascular therapy, resulting in an approximated incidence of 0.29% of all implanted devices. The overall procedural success rate was 96.9%. With regard to the patients who underwent successful endovascular treatment, the culprit lesion was located in the common femoral artery in 22 (71.0%) cases, the femoral artery bifurcation in 3 (9.7%) cases and the superficial femoral artery in 6 (19.4%) cases. Ten (31.3%) patients had thrombosis in other distal lower limb arteries ipsilateral to Angio-sealTM use. Eighteen (58.1%) patients underwent balloon angioplasty alone, while nine (29.0%) patients underwent balloon angioplasty and thrombolysis, and four (12.9%) patients underwent stent implantation. One patient suffered from minor bleeding at the site of application of the Angio-sealTM . During an average of 43.5 ± 22.9 months of follow-up, three patients with symptomatic restenosis underwent a second successful balloon angioplasty and remained asymptomatic until the last follow-up.

Conclusions: Balloon angioplasty with selective thrombolysis or stent placement was safe and effective, with a low incidence of complication and restenosis. © 2017 Wiley Periodicals, Inc.

Keywords: Angio-seal; acute limb ischemia; balloon angioplasty; stents; vascular closure devices.

MeSH terms

  • Acute Disease
  • Aged
  • Angioplasty, Balloon* / adverse effects
  • Angioplasty, Balloon* / instrumentation
  • Arterial Occlusive Diseases / diagnostic imaging
  • Arterial Occlusive Diseases / etiology
  • Arterial Occlusive Diseases / physiopathology
  • Arterial Occlusive Diseases / therapy*
  • China
  • Databases, Factual
  • Female
  • Femoral Artery* / diagnostic imaging
  • Femoral Artery* / physiopathology
  • Humans
  • Ischemia / diagnostic imaging
  • Ischemia / etiology
  • Ischemia / physiopathology
  • Ischemia / therapy*
  • Lower Extremity / blood supply*
  • Male
  • Middle Aged
  • Recurrence
  • Retreatment
  • Retrospective Studies
  • Risk Factors
  • Stents
  • Thrombolytic Therapy* / adverse effects
  • Thrombosis / diagnostic imaging
  • Thrombosis / etiology
  • Thrombosis / physiopathology
  • Thrombosis / therapy*
  • Time Factors
  • Treatment Outcome
  • Vascular Closure Devices / adverse effects*