Fluoroscopy‐guided snare retrieval of the celt ACD<sup>®</sup> metallic vascular closure device following failed deployment

Cahill, Thomas J.; Choji, Kiyoshi; Kardos, Attila

doi:10.1002/ccd.25229

Cited by 12 publications

(4 citation statements)

References 8 publications

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“…However, cases of successful retrieval of embolised Angio-Seal® devices through endovascular approaches have been reported (Suri et al 2015; Jud et al 2017). The successful endovascular retrieval of a distally embolised Celt ACD®, following primary device failure, was reported by Cahill et al (Cahill et al 2013). The device was visualised fluoroscopically and found to be situated in the common femoral artery.…”

Section: Discussionmentioning

confidence: 86%

Successful surgical retrieval of Celt ACD® vascular closure device embolised in the tibioperoneal trunk

et al. 2018

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BackgroundThis report presents a case of surgical retrieval of a Celt ACD® vascular closure device (VCD) situated in the tibioperoneal trunk, following a failed attempt at deployment. Existing literature mostly recommends an endovascular approach when attempting to retrieve embolised VCDs.Case presentationA 55 year old male presented with right sudden right lower limb pain and numbness 1 week following a successful left retrograde superficial femoral artery (SFA) angioplasty. Computed tomography (CT) angiogram revealed that the Celt ACD® VCD had embolised in the right tibioperoneal trunk. An endovascular approach was initially attempted to retrieve the VCD; however, this was unsuccessful due to the small diameter of the target artery. Due to the failure of the endovascular approach, surgical exploration of the right tibioperoneal trunk was undertaken, which led to the successful retrieval of the embolised VCD.ConclusionThe case presented herein demonstrates the critical need for swift and decisive surgical exploration of patients with suspected embolisation of Celt ACD® devices in smaller distal arteries. Our experience has led to the recommendation that, due to the sharp edges of the Celt ACD® accompanied with the small diameter of the occluded vessels, surgical exposure and retrieval is the safest option if endovascular retrieval is unsuccessful.

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Section: Discussionmentioning

confidence: 86%

Successful surgical retrieval of Celt ACD® vascular closure device embolised in the tibioperoneal trunk

et al. 2018

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“…The endoluminally-anchored part of the implant poses the risk of intravascular device migration with luminal obstruction and flow limitation. [16][17][18] Furthermore, the device proved inapplicable in acute vascular access angles between 70° and 90°, occurring in antegrade approaches. Thus, we suggest ultrasound guidance for the initial antegrade puncture, in order to achieve an access angle of less than 50°.…”

Section: Discussionmentioning

confidence: 99%

A novel double clip-based vascular closure device in antegrade and retrograde femoral punctures: A single-center experience in peripheral non-cardiac procedures

et al. 2021

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Background: This retrospective study investigates the efficacy and safety of the novel Celt ACD® vascular closure device (VCD) following antegrade and retrograde common femoral artery (CFA) punctures for the treatment of peripheral artery disease in a challenging patient collective (e.g. calcifications, obesity, and anticoagulation). Methods: A total of 208 VCDs (i.e. 100 antegrade and 108 retrograde) were deployed between October 2019 and December 2020 in a tertiary referral interventional radiology department. Fifty-two devices were undersized in relation to the introducer sheath (up to 2 Fr). Technical success and VCD related complications were evaluated in the immediate post procedure period and the following 24 h clinically. In 68% of cases, additional duplex ultrasound was performed prior to discharge. Results: The overall technical success rate was 97%. Technical failures following antegrade approach were due to a too acute access angle (⩾60°), rendering it impossible to pass the applicator tip through the sheath lumen. A subgroup analysis of technical success pinpoints severe calcification as another key limiting factor in VCD use ( p = 0.004). Comparing equally sized with undersized device selection ( p = 0.196), direction of approach ( p = 0.265), and body mass index ( p = 0.184) proved to be insignificant. Five (2%, 5/208) major complications occurred: Four antegrade (i.e. one false aneurysm, one vessel laceration with retroperitoneal hemorrhage, two device migrations; 4%, 4/100) and one following retrograde access (i.e. >6 cm hematoma, 1%, 1/108)). Complications were successfully managed with manual compression or interventional procedures. Conclusions: The novel clip-based VCD proved to be effective with a low VCD related complication rate.

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“…A standard conventional surgical embolectomy has been traditionally performed to manage distal device embolization [ 7 , 8 ]. However, more recent endovascular approaches have challenged the traditional surgical approach, with promising results being reported [ 5 , 9 , 10 ].…”

Section: Discussionmentioning

confidence: 99%

Endovascular Management of Superficial Femoral Artery Occlusion Secondary to Embolization of Celt ACD® Vascular Closure Device

et al. 2020

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Fluoroscopy‐guided snare retrieval of the celt ACD^® metallic vascular closure device following failed deployment

Cited by 12 publications

References 8 publications

Successful surgical retrieval of Celt ACD® vascular closure device embolised in the tibioperoneal trunk

Successful surgical retrieval of Celt ACD® vascular closure device embolised in the tibioperoneal trunk

A novel double clip-based vascular closure device in antegrade and retrograde femoral punctures: A single-center experience in peripheral non-cardiac procedures

Endovascular Management of Superficial Femoral Artery Occlusion Secondary to Embolization of Celt ACD® Vascular Closure Device

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Fluoroscopy‐guided snare retrieval of the celt ACD® metallic vascular closure device following failed deployment

Cited by 12 publications

References 8 publications

Successful surgical retrieval of Celt ACD® vascular closure device embolised in the tibioperoneal trunk

Successful surgical retrieval of Celt ACD® vascular closure device embolised in the tibioperoneal trunk

A novel double clip-based vascular closure device in antegrade and retrograde femoral punctures: A single-center experience in peripheral non-cardiac procedures

Endovascular Management of Superficial Femoral Artery Occlusion Secondary to Embolization of Celt ACD® Vascular Closure Device

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Fluoroscopy‐guided snare retrieval of the celt ACD^® metallic vascular closure device following failed deployment