chemoembolization (n ¼ 3), trauma embolization (n ¼ 2), upper arm revascularization/embolization (n ¼ 29) and uterine artery embolization (n ¼ 6). Clinical hemostasis success was correlated with artery accessed, sheath size and heparin dose. Results: Puncture site clinical hemostasis was 100% using the device. Mean fluoroscopic time was 26 min. Left radial access was the most common (46%) with median sheath size of 4 F (range 4-7 F). Access sites grouped into upper limb (radial/ brachial/ulnar, n ¼ 48) and lower limb (pedal, n ¼ 24) showed a mean time to hemostasis in the upper limb group of 22 min, significantly shorter than the lower limb group at 41 min (P ¼ 0.007). Mean heparin dose in the upper limb group was 4023 units compared to 7952 units in the lower limb group (Po0.001). Three patients (4.3%) had mild upper limb ecchymosis at initial follow-up that resolved without event. One patient developed radial artery occlusion (1.4%) 3 days after device placement. Conclusions: Use of a novel device for upper limb and pedal arterial access hemostasis was safe and effective. Shorter time to hemostasis was observed in the upper limb group of patients which may be attributable to lower mean heparin dose. A low rate of arterial access occlusion was observed compared to other reported radial compression devices.
In a patient with mitral stenosis, transthoracic echocardiography revealed a
left atrial appendage thrombus. A repeat study performed after 4 weeks of oral
anticoagulant therapy demonstrated the disappearance of the left atrial clot.
These findings were subsequently confirmed by transesophageal echocardiography
which also revealed left atrial spontaneous contrast echoes.
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