How to avoid common femoral artery occlusion by the suture-mediated vascular closure device (Perclose ProGlide)?

Final ID:

2104 

Authors:

I Lee1, H Kim2

Institutions:

1National Cancer Center, Goyang-Si, Gyeonggi-Do, 2National Cancer Center, Goyang-si, Gyeonggi-do

First Author:

In Joon Lee, MD, PHD  
National Cancer Center
Goyang-Si, Gyeonggi-Do

Co-Author:

Hyun Beom Kim  
National Cancer Center
Goyang-si, Gyeonggi-do

Presenting Author:

In Joon Lee, MD, PHD  
National Cancer Center
Goyang-Si, Gyeonggi-Do

Learning Objectives:

The learning objective of this presentation is to understand the possible mechanism of common femoral artery(CFA) occlusion by the Perclose ProGlide, and how to avoid this complication.

Background:

Perclose ProGlide is the second-generation suture-mediated vascular closure device. It can reduce the time until hemostasis and achieve patients' early ambulation. Because its mechanism of deployment is complicated, technical failure and complication could occur early in the experience (learning curve). In our hospital, CFA occlusion was a very thorny issue.

Clinical Findings/Procedure Details:

From 2014 to 2017, 1295 common femoral arteries were closed with Perclose ProGlide device after chemoembolization for hepatocellur carcinoma. In the first two years, CFA occlusion occurred in 7 (2.0%) of 347 cases, and balloon angioplasty alone (n=6) and bailout stent placement (n=1) were performed additionally. We realized what was wrong with handling the device. Those complications occurred mainly in a high femoral artery puncture. Perclose ProGlide device would be deployed at a lower angle in those cases, and therefore, the anterior and posterior artery walls were sutured together. After that realization, there was no complications in the remaining 948 cases.

Conclusion and/or Teaching Points:

In this presentation, we will share radiological images, endovascular treatment, and possible mechanism of CFA occlusion by the Perclose ProGlide and technical tips to avoid it.

Abstract Categories:

Arterial Interventions: Other

Keywords:

Closure device
Common femoral artery
Complications