Jetstream atherectomy and balloon angioplasty with distal embolic protection for Angio-Seal related vascular access complications

Cardiovasc Interv Ther. 2018 Jul;33(3):264-269. doi: 10.1007/s12928-017-0478-5. Epub 2017 Jun 28.

Abstract

Arteriotomy closure devices (ACDs) are routinely used for vascular closure during invasive cardiovascular procedures. They decrease time to hemostasis as well as length of stay. Major complications such as arterial ischemia and occlusion can be encountered in a minority of patients. We are describing a series of 3 patients with access site closure using Angio-Seal after coronary angiography who developed intermittent claudication within 2-3 weeks of follow-up. Access site thrombosis/stenosis in the CFA was found in all the three cases. They were successfully revascularized using Jetstream atherectomy with embolic protection filter followed by balloon angioplasty. This technique can treat extensive thrombus burden as well as extract the collagen and foot plate of Angio-Seal through atherectomy with cutting blades and thrombectomy via rheolytic macerating aspiration port. All cases had excellent angiographic and clinical results.

Keywords: Angio-Seal related occlusion; Atherectomy; Balloon angioplasty; Embolic protection.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aged, 80 and over
  • Angioplasty, Balloon, Coronary / methods*
  • Atherectomy / methods*
  • Coronary Angiography / adverse effects*
  • Coronary Angiography / methods
  • Embolic Protection Devices
  • Female
  • Femoral Artery / pathology
  • Femoral Artery / surgery
  • Humans
  • Ischemia / etiology
  • Ischemia / surgery
  • Postoperative Complications / surgery*
  • Treatment Outcome
  • Vascular Closure Devices / adverse effects*