Percutaneous transluminal angioplasty of suture-mediated closure device-related femoral artery stenosis or occlusive disease

• Published in: British journal of radiology 2009-06, Vol.82 (978), p.486-490
• Main Authors: Kim, Y-J, Yoon, H-K, Ko, G-Y, Shin, J-H, Sung, K-B
• Format: Article
• Language: English
• Subjects: Adult; Aged; Angiography; Angioplasty, Balloon; Arterial Occlusive Diseases - etiology; Arterial Occlusive Diseases - therapy; Constriction, Pathologic - etiology; Constriction, Pathologic - therapy; Female; Femoral Artery; Hemostasis, Surgical - adverse effects; Humans; Intermittent Claudication - etiology; Leg - blood supply; Male; Middle Aged; Paresthesia - etiology; Suture Techniques - adverse effects
• ISSN: 0007-1285; 1748-880X
• DOI: 10.1259/bjr/25029516

This study evaluates the efficacy of percutaneous transluminal balloon angioplasty (PTA) to treat stenosis or occlusion following haemostasis using a suture-mediated closure (SMC) device. Steno-occlusion occurred in 7 (0.4%) patients, some with claudication, others without. Steno-occlusion was diagnosed immediately after haemostasis in the four patients without claudication, but diagnosis was delayed in all three patients with claudication. Six of the patients subsequently underwent PTA using a contralateral femoral arterial approach. Technical success, clinical response and vessel patency were evaluated retrospectively. Follow-up angiography revealed focal segmental steno-occlusion (1 cm) in the external iliac and common femoral arteries in three patients. PTA was technically successful in all patients (6/6, 100%). Among the three patients who developed delayed onset of claudication, one declined treatment and the claudication improved in two. Doppler ultrasound obtained 28-129 days (mean; 75 days) after PTA revealed patent arterial flow in six patients. One patient with delayed-onset occlusion refused the procedure because the symptoms were mild. This study has shown that PTA is a useful treatment for steno-occlusion following haemostasis using the SMC device. Careful angiography and review of the femoral bifurcation prior to use of an SMC device is important.