Ultrasound-guided Femoseal® vascular closure device in antegrade common femoral artery puncture

Abstract

Aim: To retrospectively review the efficacy and safety of ultrasound-guided Femoseal vascular closure device in antegrade common femoral artery puncture after peripheral arteries revascularization.

Methods: We reviewed the hemostatic outcome achieved with DUS guided FemoSeal in patients undergoing antegrade common femoral artery accesses for percutaneous lower limbs revascularization using 6- to 8-Fr vascular sheaths. Exclusion criteria were known bleeding or coagulation disorder, previous femoral artery punctures within 1 month and/or previous common femoral artery vascular interventions. Primary endpoint was technical success. Secondary endpoints were access complications and need for reintervention.

Results: A total of 301 patients (250 M; 51 F) were included in the study. Technical success was achieved in 99%. One pseudoaneurysm (0.3%) developed in the first post-operative day and was treated with Human Thrombin Injection. Two more pseudoaneurysms were found during follow-up at the first 1 month US scan. Two conversions to manual compression occurred.

Conclusion: The use of ultrasound-guided FemoSeal VCD in antegrade CFA puncture demonstrated high technical success and a low complication rate. These findings suggest that it is a safe and effective option for achieving hemostasis in patients undergoing percutaneous lower limb revascularization. Further studies with larger cohorts and longer follow-up may help confirm these results and refine patient selection criteria.

Keywords: FemoSeal; PAD; Vascular closure devices; antegrade puncture.