Groin Infection Caused by a Percutaneous Femoral Artery Closure Device: Report of a Case

Hemostasis after femoral artery catheterization is generally achieved by manual compression, which results in a low incidence of infection at the puncture site. Percutaneous femoral artery closure devices have recently been used to prevent bleeding complications, shorten the hospital stay, and reduce the patient's discomfort. However, they have been associated with infectious complications, necessitating surgical intervention, such as patch angioplasty or arterial bypass; the treatment depending on the damage to the artery and the type of device used. Thus, the possibility of infection should be kept in mind when employing these devices. We report a case of groin infection associated with one such device, known as The Closer, which was successfully treated by drainage and removal of the suture material.     

经皮股动脉穿刺点采用血管封堵器止血患者的护理

目的 探讨血管封堵器对血管性介入术后股动脉穿刺点止血的护理方法.方法 55例患者行血管介入诊断治疗术后,股动脉穿刺点采用Angioseal封堵器止血,分析止血效果,观察有无植入部位出血和血肿、动脉血栓形成或栓塞及股动脉损伤等血管性并发症.结果 血管封堵器止血成功率为98.2%,止血时间为(3.60±0.55)min,下床活动时间为(4.20±0.45)h;未发生严重并发症;股动脉穿刺点彩色多普勒超声随访未发现血管病变.结论 血管封堵器对股动脉穿刺点能快速、有效地止血,患者能提前下床活动,及时、科学的护理可减少不良反应.     

经皮股动脉穿刺点采用血管封堵器止血患者的护理

目的探讨血管封堵器对血管性介入术后股动脉穿刺点止血的护理方法。方法55例患者行血管介入诊断治疗术后，股动脉穿刺点采用Angioseal封堵器止血，分析止血效果，观察有无植入部位出血和血肿、动脉血栓形成或栓塞及股动脉损伤等血管性并发症。结果血管封堵器止血成功率为98．2％，止血时间为（3．60±0．55）min，下床活动时间为（4．20±0．45）h；未发生严重并发症；股动脉穿刺点彩色多普勒超声随访未发现血管病变。结论血管封堵器对股动脉穿刺点能快速、有效地止血，患者能提前下床活动，及时、科学的护理可减少不良反应。     

Management of Vascular Complications following Femoral Artery Catheterization with and without Percutaneous Arterial Closure Devices

Percutaneous arterial closure devices allow earlier mobilization and discharge of patients after arterial catheterization than with manual compression for puncture site hemostasis. We reviewed our recent experience managing the complications of femoral artery catheterization with and without these devices on the vascular surgery service at a tertiary hospital. Thirty-one patients presenting over an 18-month period with complications after femoral artery catheterization with manual compression (n = 21) or percutaneous arterial closure devices (n = 10) were retrospectively reviewed.     

Treatment of Femoral Artery Pseudoaneurysms with Percutaneous Thrombin Injection

The objective of this study was to prospectively evaluate the efficacy of ultrasound-guided thrombin injection for the treatment of post-catheterization femoral artery pseudoaneurysms. Between August 1, 1998 and August 31, 1999, 38 patients underwent ultrasound-guided injection of thrombin into 39 femoral false aneurysms. Peripheral pulses and ankle/brachial indices were assessed before and after the injection. Patients were followed with a control duplex scan within 4 weeks. The good results from this study showed that ultrasound-guided thrombin injection is an effective method for the treatment of post-catheterization false aneurysms. In a minority of patients, signs consistent with arterial embolization or vasospasm were identified.     

Acute Aortic Dissection Presenting as Rupture of the Femoral Artery

A 44-year-old male with Marfans disease presented acutely with severe chest and left groin pain. A pulsatile mass was present in the left groin and the left leg was pale and pulseless. CT imaging demonstrated the presence of a distal thoracic aortic dissection (AD) involving the left iliofemoral segment with extravasation of contrast into the left groin. The patient was treated with an urgent femoral-femoral bypass, which repaired the femoral artery and restored perfusion to the left lower extremity. Whereas rupture of the aorta into the chest or pericardium is common, femoral artery rupture complicating AD has not been previously reported. This case illustrates the need for peripheral branch intervention when compromised by the dissection process including isolated iliofemoral segments, which are typically benign. Given frank femoral artery rupture, urgent surgical repair was required and resulted in a satisfactory outcome. Presented at the Annual Meeting of the Southern California Vascular Surgical Society, Carlsbad, CA, April 11-13, 2003.     

Deep Femoral Artery Aneurysm: Report of a Case

Aneurysms involving the deep femoral artery, otherwise known as the profunda femoris artery (PFA), are extremely rare. Rarer still are bilateral PFA aneurysms (PFAAs). The diagnosis is difficult, but it may be suggested by the presence of a pulsatile tumor in the region of the femoral artery or by symptoms resulting from complications such as rupture or thromboembolism. A high index of suspicion is essential to diagnose them because they may present atypically. Surgery remains the treatment of choice and should be carried out electively for asymptomatic aneurysms. Surgery in an emergency situation can be challenging, especially when it involves vascular reconstruction as dictated by the peripheral vascular circulation.