Ultrasonographic features of vascular closure devices: initial and 6-month follow-up results

Abstract

Purpose:This study aimed to evaluate the ultrasonographic findings for various types of vascular closure devices (VCDs) immediately after the angiographic procedure and at 6-month follow-up.Methods:We included 18 VCDs including Angio-Seal (n=4), FemoSeal (n=8), ExoSeal (n=3), Perclose (n=2), and StarClose (n=1) in this study. Four patients were implanted with 2 VCDs at the each side of bilateral femoral arteries, while the remaining 8 patients were inserted 1 VCD at the right femoral artery. Ultrasonography was performed within 10 days and at approximately 6 months after the angiographic procedure. Ultrasonographic morphology of the attached VCD and its relationship with the arterial wall were analyzed.Results:Initial ultrasonography revealed the attached VCD as the relevant unique structure with successful deployment and hemostasis. Follow-up ultrasonography demonstrated partial absorption of hemostatic materials in cases of Angio-Seal (n=3), FemoSeal (n=5), and ExoSeal (n=3), changes in the soft tissue surrounding the femoral artery in case of Angio-Seal (n=1), arterial intimal hyperplasia in cases of FemoSeal (n=3), and no gross changes as compared with the initial ultrasonographic findings in cases of Perclose (n=2) and StarClose (n=1).Conclusion:Initial ultrasonographic evaluation reflected the unique structure of each VCD, with most of them being easily distinguishable. Follow-up ultrasonography revealed various changes in the affected vessels.

Flip-over of blood vessel intima caused by vascular closure device: A case report

“…The surgeon should pull the handle of the closure device linearly[ 14 ] and then remove it smoothly. Studies have shown that the release of the vascular closure device under ultrasound guidance can reduce the number of complications[ 15 - 17 ]. In addition, although the vascular closure device has significant advantages in closing large-sized blood vessels, its operation is complicated[ 18 ].…”

Efficacy and Safety of Ultrasound-Guided Repeat Access and Repeat Closure With an ExoSeal Vascular Closure System in Patients With Peripheral Arterial Disease

“…Boschewitz et al 6 previously showed the efficacy of repeat ExoSeal closure but did not examine the time dependence. After implantation, Exo-Seal has been suggested to absorb completely in 2 to 3 months, but Choo et al 9 found only partial absorption of an ExoSeal implant in follow-up ultrasound at 6 months. Thus, it is possible that the interval between ExoSeal implantation and complete absorption may differ among individuals.…”

Suitability of a 7-F ExoSeal Vascular Closure Device for Femoral Artery Punctures Made by 8-F or 9-F Introducer Sheaths

“…Third, it is an anchorless device that releases only a bioabsorbable plug entirely into the extravascular space, so it does not easily influence intra-arterial wall responses such as intimal hyperplasia. 13 Therefore, it is suitable for repeated punctures and site closures. 4 There are some reports that describe off-label use of ExoSeal VCDs for antegrade puncture closure 3,6,8 or in arteries other than of the CFA.…”