Endovascular therapy for Angio-seal TM -related acute limb ischemia: Perioperative and long-term results.

OBJECTIVES: To investigate the perioperative and long-term outcomes of endovascular therapy for Angio-sealTM -related acute limb ischemia.

BACKGROUND: Currently, limited data are available on the optimal treatment strategy for Angio-sealTM -related acute lower limb ischemia.

METHODS: The prospectively maintained patient database of our institution was retrospectively searched to identify all patients who developed acute lower limb ischemia after use of the Angio-SealTM and received endovascular treatment from January 2010 to February 2016. The clinical and follow-up data were evaluated.

RESULTS: Thirty-two patients with Angio-SealTM -related acute limb ischemia underwent endovascular therapy, resulting in an approximated incidence of 0.29% of all implanted devices. The overall procedural success rate was 96.9%. With regard to the patients who underwent successful endovascular treatment, the culprit lesion was located in the common femoral artery in 22 (71.0%) cases, the femoral artery bifurcation in 3 (9.7%) cases and the superficial femoral artery in 6 (19.4%) cases. Ten (31.3%) patients had thrombosis in other distal lower limb arteries ipsilateral to Angio-sealTM use. Eighteen (58.1%) patients underwent balloon angioplasty alone, while nine (29.0%) patients underwent balloon angioplasty and thrombolysis, and four (12.9%) patients underwent stent implantation. One patient suffered from minor bleeding at the site of application of the Angio-sealTM . During an average of 43.5 ± 22.9 months of follow-up, three patients with symptomatic restenosis underwent a second successful balloon angioplasty and remained asymptomatic until the last follow-up.

CONCLUSIONS: Balloon angioplasty with selective thrombolysis or stent placement was safe and effective, with a low incidence of complication and restenosis. © 2017 Wiley Periodicals, Inc.