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Cho HJ, Jeon CH, Kim MH, Lee JM, Hwang JK. Ultrasonography-guided endovascular management of femoral artery pseudoaneurysm after unintended dialysis catheterization with suture-mediated vascular closure devices. J Vasc Access 2022:11297298221130895. [PMID: 36262020 DOI: 10.1177/11297298221130895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022] Open
Abstract
Although iatrogenic pseudoaneurysm is an infrequent complication, it can be life threatening if ruptured. There are several treatment methods for managing this complication. This case report demonstrates a technique using ultrasonography-guided suture-mediated vascular closure devices without angiography to successfully treat iatrogenic superficial femoral pseudoaneurysm following an unintended hemodialysis catheter insertion. In particular, when it is difficult to use a contrast due to a patient's condition as in this case, suture-mediated vascular closure device with ultrasonography guidance can be used as a therapeutic method.
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Affiliation(s)
- Hyung-Jin Cho
- Division of Vascular and Tranplant Surgery, Department of Surgery, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Chang Ho Jeon
- Department of Radiology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Mi-Hyeong Kim
- Division of Vascular and Tranplant Surgery, Department of Surgery, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jeong-Min Lee
- Department of Radiology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jeong-Kye Hwang
- Division of Vascular and Tranplant Surgery, Department of Surgery, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Lareyre F, Mialhe C, Bourlon F, Habib Y, Dommerc C, Raffort J. Diabetes mellitus is not associated with worse vascular outcome following percutaneous transfemoral transcatheter aortic valve implantation. Acta Cardiol 2019; 74:480-486. [PMID: 30642229 DOI: 10.1080/00015385.2018.1522074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background: Transcatheter aortic valve implantation (TAVI) is an alternative to open surgical aortic valve replacement and the impact of diabetes on vascular outcomes is worth of investigation. The aim of our study was to determine if diabetic patients had distinct pre-operative characteristics compared to non-diabetics and to evaluate the impact of the disease on vascular outcomes.Methods: Four hundred consecutive patients who underwent TAVI with percutaneous transfemoral access were retrospectively included. Vascular outcomes were classified according to the Valve Academic Research Consortium 2 classification.Results: Seventy-eight (19.5%) patients were diabetics. Compared to non-diabetics, diabetic patients were younger and had significantly higher body mass index (29.7+/- 0.7 kg/m2 vs 26.8+/- 0.3, p < .0001), higher proportion of associated dyslipidemia (34.6% vs 11.5%, p < .0001) and arterial hypertension (60% vs 38.2%, p = .0009). Anatomical characteristics of the vascular access and procedural characteristics did not differ among the groups. No significant difference was observed in the incidence of major and minor vascular complications and 30-day post-operative mortality between diabetic and non-diabetic patients (2.6% vs 1.9%, p = .6916).Conclusion: Diabetes is not associated with worse vascular outcome following TAVI suggesting that the vascular access can be managed safely in these patients.
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Affiliation(s)
- Fabien Lareyre
- Cardiovascular Surgery Unit, Cardio Thoracic Centre of Monaco, Monaco
- Université Côte d’Azur, Nice, France
| | - Claude Mialhe
- Cardiovascular Surgery Unit, Cardio Thoracic Centre of Monaco, Monaco
| | - François Bourlon
- Cardiovascular Surgery Unit, Cardio Thoracic Centre of Monaco, Monaco
| | - Yacoub Habib
- Cardiovascular Surgery Unit, Cardio Thoracic Centre of Monaco, Monaco
| | - Carine Dommerc
- Cardiovascular Surgery Unit, Cardio Thoracic Centre of Monaco, Monaco
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Giordano A, Corcione N, Ferraro P, Morello A, Conte S, Testa L, Iadanza A, Sardella G, Mancone M, Berti S, Petronio AS, Romagnoli E, Pepe M, Frati G, Biondi-Zoccai G. Comparison of ProGlide vs. Prostar in patients undergoing transcatheter aortic valve implantation. Minerva Cardioangiol 2019; 67:443-449. [PMID: 31670491 DOI: 10.23736/s0026-4725.19.05071-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Arturo Giordano
- Unit of Cardiovascular Interventional Medicine, Pineta Grande Hospital, Castel Volturno, Caserta, Italy
| | - Nicola Corcione
- Unit of Cardiovascular Interventional Medicine, Pineta Grande Hospital, Castel Volturno, Caserta, Italy
| | - Paolo Ferraro
- Unit of Hemodynamics, Santa Lucia Hospital, San Giuseppe Vesuviano, Naples, Italy
| | - Alberto Morello
- Unit of Cardiovascular Interventional Medicine, Pineta Grande Hospital, Castel Volturno, Caserta, Italy
| | - Sirio Conte
- Unit of Hemodynamics, Santa Lucia Hospital, San Giuseppe Vesuviano, Naples, Italy
| | - Luca Testa
- Department of Cardiology, San Donato Polyclinic IRCCS, San Donato Milanese, Milan, Italy
| | - Alessandro Iadanza
- Unit of Hemodynamics, Department of Cardiac, Thoracic and Vascular Sciences, Santa Maria alle Scotte Polyclinic, Siena, Italy
| | - Gennaro Sardella
- Department of Cardiovascular, Respiratory, Nephrological, Anaesthetic and Geriatric Sciences, Umberto I Polyclinic, Sapienza University, Rome, Italy
| | - Massimo Mancone
- Department of Cardiovascular, Respiratory, Nephrological, Anaesthetic and Geriatric Sciences, Umberto I Polyclinic, Sapienza University, Rome, Italy
| | - Sergio Berti
- G. Monasterio C.N.R. Foundation, Ospedale del Cuore, Massa, Italy
| | - Anna S Petronio
- Department of Cardiology, AOUP Cisanello, University Hospital of Pisa, Pisa, Italy
| | - Enrico Romagnoli
- Institute of Cardiology, A. Gemelli University Polyclinic, IRCCS and Foundation, Sacred Heart Catholic University, Rome, Italy
| | - Martino Pepe
- Division of Cardiology, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Giacomo Frati
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, Rome, Italy
- IRCCS NEUROMED, Pozzili, Isernia, Italy
| | - Giuseppe Biondi-Zoccai
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, Rome, Italy -
- Mediterranea Cardiocentro, Naples, Italy
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De Palma R, Settergren M, Rück A, Linder R, Saleh N. Impact of percutaneous femoral arteriotomy closure using the MANTA TM device on vascular and bleeding complications after transcatheter aortic valve replacement. Catheter Cardiovasc Interv 2018; 92:954-961. [PMID: 29575678 DOI: 10.1002/ccd.27595] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2017] [Accepted: 02/23/2018] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To evaluate the feasibility of fully percutaneous closure using a novel collagen-based vascular closure device after transfemoral aortic valve replacement (TAVR). BACKGROUND TAVR is utilized increasingly for the treatment of severe symptomatic aortic stenosis. Vascular complications related to access and closure dominate the adverse event profile of the procedure despite progressively reducing arteriotomy caliber. The advent of a novel collagen-based device (MANTATM ) and preliminary data suggest this could be used as a routine percutaneous closure device. METHODS A prospective observational study of unselected consecutive patients undergoing TAVR in a single center. Data were collected via hospital electronic records and the SWEDEHEART registry. The primary clinical outcome was closure success and time to hemostasis. Secondary outcomes included VARC-2 defined major and minor vascular and bleeding complications within 30 days using suture-based closure with Prostar-XL within the same center. RESULTS A consecutive cohort of 346 patients underwent TAVR via the transfemoral approach. Vascular closure with MANTATM was successful in all with a mean time to hemostasis of 42 sec (SD 115.5, range 0-600). The composite of all-cause mortality and major complications related to the main access site was similar between the groups (1.1% vs 1.9%, P = .61). Major bleeding occurred less frequently with MANTA TM (1.1% vs 7.8%, P = .02). CONCLUSION The novel use of a collagen-based vascular closure device for large caliber arteriotomy is feasible in an unselected population undergoing transfemoral TAVR and appears efficacious compared to percutaneous suture-based closure. These data should prompt larger studies to evaluate efficacy and safety.
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Affiliation(s)
- Rodney De Palma
- Heart and Vascular theme, Karolinska University Hospital and department of Medicine, Karolinska Institutet, Karolinska vägen, 171 76 Solna, Stockholm, Sweden
| | - Magnus Settergren
- Heart and Vascular theme, Karolinska University Hospital and department of Medicine, Karolinska Institutet, Karolinska vägen, 171 76 Solna, Stockholm, Sweden
| | - Andreas Rück
- Heart and Vascular theme, Karolinska University Hospital and department of Medicine, Karolinska Institutet, Karolinska vägen, 171 76 Solna, Stockholm, Sweden
| | - Rikard Linder
- Heart and Vascular theme, Karolinska University Hospital and department of Medicine, Karolinska Institutet, Karolinska vägen, 171 76 Solna, Stockholm, Sweden
| | - Nawzad Saleh
- Heart and Vascular theme, Karolinska University Hospital and department of Medicine, Karolinska Institutet, Karolinska vägen, 171 76 Solna, Stockholm, Sweden
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