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Discussion

Angioseals

I Was Wondering If Any Of The Cath Lab Nurses Out There Have Seen A Clot As A Side Effect To Angioseal. I Use To Do Cath Lab Recovery But It Has Been A Few Years. What Do You Think About The Angioseal?

Frogern

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  • Admin

Do you mean, an acute arterial clot in the site leg? Have you done any internet search for complications r/t Angioseal? What are the manufacturer's warnings?

Here's one article I found:

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11146512&dopt=Abstract

and another:

http://www.sigmund-silber.com/english/moreabstracts/moreab2.htm

and another:

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16483343&dopt=Abstract

Perhaps you'll get different, more specific articles and information using different search words (I used "angioseal complications").

I have seen one acute occlusion of the femoral artery, related to Angioseal deployment technique (IMO).

My only concern about using Angioseal is increased risk of infection r/t insertion of a foreign substance. I have seen two pts return for groin problems post-cath, who were admitted and treated for cellulitis.

Ask questions, dig for answers!! -- D

I work on cardiac telemetry, we get a lot of post-caths. I saw a weird thing with an angioseal once - this guy got up before his bedrest was over and started bleeding (not a gusher, but more than an ooze). Anyway, the nurse responded, got him back in bed, and started holding pressure. As she pressed down with some 4x4's, this large (about 2 inches in diameter) clot came out of his groin site - thing was, it was like a doughnut. It had a hole in the middle and was perfectly round. Weird. Anyway, we called the Dr. and held pressure a little longer, sent the guy home later that day. Anyone seen anything like this? Also, anyone had any experience with a Starclose?

  • Admin

We've just started using StarClose (last two months). The Cardiologists seem to like it; learning curve isn't really steep, it seems simple to use. Nice to have something to use if the INR is a little elevated. What questions do you have about it? The field rep came in for a week, and is doing monthly f/u visits (as we have Cardiology Fellows who rotate in every month)

Re: your donut-shaped clot post-AngioSeal: if there was a small leak and pressure was held post-deployment, that would have created a crater in the hematoma, which then came out the shape you saw. Just throwing some ideas out!

The Starclose, just arrived here in our facility about 3 months ago, and they seem to be pretty good. I really haven't had one problem w/ them. I really don't care for either the Perclose or the Angio/Vaso-seal devices since I've seen problems w/ them several times. Here's a link to Abbott that shows the Starclose and how it works a little better: http://www.abbottvascular.com/products/product.php?id=101 .

over all i like the angioseal system, as we can ambulate patients much more quickly, but i have seen some wonderful complications!!! We now keep all angioseal patients on bed rest for one hour as we've seen far to may bleeders, but the strangest has to be one chap who complained of leakage, I couldn't see any through the dressing so i pealed it back to have a look and saw a small hard white object emerging from the insertion site, the docs said the suture had snappedm, but the scuttle thought it had just been put in wrong! (we weren't using them much at the time)

The best recovery, seems to be the patients who's sheaths are pulled on the ward, with just digital pressure.

Whisper.

PS sorry for any typing errors, on y way to bed when i saw this post.

Digital pressure is a very safe way to seal compliant patients who are not in a hurry to get off there back and out of the hospital. During PTCA you don't have that option because of platelets drugs that are given. But then again those patient are staying in the hospital a day or so anyway...

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