Title

Successful Angioplasty and Stenting of a Thrombosed Superficial Femoral Artery Secondary to Celtacd® Metallic Vascular Closure Device Embolization

Document Type

Conference Proceeding

Publication Date

5-11-2021

Publication Title

Journal of the American College of Cardiology

Abstract

Background

Arterial closure devices (ACD) improve time to hemostasis and mobilization when compared to manual compression after peripheral interventions. Hemostasis is achieved via a stainless-steel plug attached to the arterial wall. Reported complications include embolization, occlusion, infection, and fistula formation.

Case

A 62 year old male presents with left leg pain 3 month after peripheral intervention of his right leg during which a Celt ACD was used for contralateral left access site control (Fig 1). He is found to have thrombosis at the mid SFA due to an embolized Celt ACD (Fig 2). Angioplasty and stenting of the left SFA was performed at the level of obstruction with gradual balloon inflation (Fig 3)

Decision-making

Both successful endovascular retrieval of a distally embolized Celt ACD using a snare and unsuccessful retrievals necessitating surgical exploration have been reported. In this case, we were concerned the Celt is embedded in the vessel wall and attempts for retrieval could injure the vessel with the sharp cut edges of the Celt. Due to the risk for vessel perforation, a self-expanding covered stent was initially the preferred choice for re-establishing flow; however, this was not available and instead angioplasty was performed with gradual balloon inflation followed by stenting.

Conclusion

In this case, angioplasty with gradual balloon inflation was an effective and safe method in revascularizing a complete SFA obstruction due to distal embolization of a Celt ACD.

Volume

77

Issue

18

First Page

2507

Comments

70th Annual Scientific Session and Expo of the American-College-of-Cardiology (ACC), Virtual, May 15-17, 2021.

DOI

10.1016/S0735-1097(21)03862-6

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