Retrospective cohort study on Angio-Seal closure device safety and effectiveness in antegrade superficial femoral artery punctures: A comparison with antegrade common femoral artery punctures.

PURPOSE: This retrospective study evaluates the effectiveness and safety of the Angio-Seal closure device in superficial femoral artery (SFA) antegrade punctures compared to common femoral artery (CFA) antegrade punctures. METHODS: Over a period of 46 months from January 2012, consecutive patients who underwent antegrade CFA or SFA punctures using Angio-Seal as a closure device in a single centre were studied. Patients were identified by reading all the individual reports on our radiology system for all patients who underwent any angiographic examination during the study period, and their individual case notes were subsequently reviewed. A retrospective analysis of prospectively collected data on patients' demographics, type of intervention, clinical indication, Angio-Seal size, haemostasis status and complications was performed. RESULTS: Overall, 194 patients (mean (s.d.) age 74(12) years, 123(44%) males) underwent CFA or SFA antegrade punctures. A total of 228 (CFA group, n = 70, SFA group, n = 158) antegrade punctures were performed. Clinical characteristics of the two groups were comparable. Angio-Seal size 6F was deployed in 69(99%) antegrade CFA punctures and 155(98%) antegrade SFA punctures (P = 1.000). Haemostasis was achieved in 65(93%) antegrade CFA punctures compared to 156(99%) antegrade SFA punctures (P = 0.030). CONCLUSION: Angio-Seal closure device is safe and effective method of haemostasis both in antegrade SFA and CFA punctures with no significant complications or delayed discharge.

Emergency endovascular repair of iatrogenic aortocaval fistula: a rare complication of laparoscopic surgery.

We present the first reported case of iatrogenic aortocaval fistula due to trochar injury after attempted laparoscopic repair of incisional hernia. It was diagnosed with an x-ray computed tomography and successfully managed with an endovascular-covered stent graft by excluding the fistula. A follow-up computed tomography scan at 3 months did not show any recurrence.