Search Results (3)

Purpose: This study aimed to evaluate the efficacy and safety of the Angio-Seal™ VIP vascular closure device (VCD) in achieving hemostasis following percutaneous transhepatic portal venous interventions. Methods: This retrospective study evaluated 20 patients (mean age: 52.85 ± 16.18 years; 80% male) who underwent percutaneous transhepatic portal vein interventions followed by tract closure with the Angio-Seal™ device between January 2016 and September 2024. Procedural data, pre- and post-procedural hemoglobin and hematocrit levels, and complications were analyzed. Technical success was defined as the successful deployment of the device with immediate hemostasis and no evidence of bleeding on post-procedural imaging. Results: Technical success, as defined in this study, was achieved in all 20 procedures (100%). The mean hemoglobin level declined from 11.91 ± 2.01 g/dL to 11.09 ± 2.19 g/dL (p < 0.001), and the mean hematocrit level decreased from 36.18 ± 6.03% to 32.98 ± 5.80% (p = 0.001). A hemoglobin drop ≥2 g/dL occurred in two patients (10%) and a hematocrit drop ≥4% in six patients (30%); none were associated with imaging or clinical evidence of hemorrhage. No major complications were observed. Minor complications, including localized pain managed with analgesics, occurred in five patients (25%). Follow-up imaging confirmed the absence of hemoperitoneum or device-related failure. Conclusions: Angio-Seal™ is a technically feasible, safe, and effective option for tract closure following percutaneous transhepatic portal vein access. This single-device approach may offer a cost-effective alternative to traditional embolization techniques. However, more extensive prospective studies are required to validate these findings. Full article

Background: The accidental puncture of the supra-aortal arteries during central venous catheterization is a rare but potentially life-threatening complication. Traditional management often requires open surgical repair, which is associated with significant morbidity. This study evaluates an endovascular approach for managing such cases using an Angio-Seal™ vascular closure device (Terumo Medical Corporation, Somerset, NJ, USA). Methods: Between January 2010 and December 2024, 47 patients with misplaced catheters in supra-aortal arteries were treated at our institution. Of these, 37 cases involving subclavian artery catheter misplacements were managed using a standardized algorithm and form the focus of this study. Additional interventions, such as stent graft placement or balloon inflation, were performed as needed. Results: Primary technical success was achieved in 86.5% of cases. Four patients required stentgrafts and one balloon inflation for persistent extravasations. One patient developed a small subclavian pseudoaneurysm, which resolved spontaneously. Primary assisted technical success and clinical success rates were both 100%. Conclusions: This study demonstrates the efficacy and safety of our minimally invasive endovascular approach for managing subclavian artery catheter misplacements. With a high success rate, low complication rate, and the avoidance of open surgery, this algorithm offers a promising alternative for treating this rare but serious complication of central venous catheterization. Full article

Background: There are different indications for endovascular surgery in horses, mainly the treatment of guttural pouch mycosis. Traditionally, these procedures are carried out by open arteriotomy of the common carotid artery (CCA), although less invasive percutaneous ultrasound-guided carotid access (PUGCA) has been described in experimental horses. In human medicine, commercial closure systems are used to seal these arterial puncture sites and reduce complications. The aims of this study are to retrospectively describe our experience with PUGCA in clinical cases and to report, for the first time, the use of the commercial vascular closure device Angio-Seal after PUGCA in horses. Methods: Retrospective study of clinical case records. Collected parameters, including the feasibility of the PUGCA and variables related to the safety and efficacy of the use of the Angio-Seal. Results: Twelve PUGCA procedures in 11 horses were included. In all cases, the artery was effectively accessed, and the planned procedure could be performed. In two cases, haematoma/bleeding due to incorrect use of the Angio-Seal was recorded. This complication rate (16.66%) was lower than that obtained in other studies using PUGCA in horses, but where the puncture was sealed by manual compression only. Main limitations: A control group of clinical cases with PUGCA but without using Angio-Seal is not available. Conclusions: Clinical data confirm previous experimental results, which showed that PUGCA is safe and effective in horses. The Angio-Seal system, regardless of possible complications due to incorrect use, can be used safely and effectively in horses. Further studies comparing arterial access site management using manual compression or Angio-Seal would be necessary to state if its routine use in horses is advisable. Full article