Explantation of Infected Hemostatic Puncture Closure Devices

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Abstract
Hemostatic puncture closure devices for the femoral artery are currently marketed as a means of shortening hemostasis, ambulation, and observation times after cardiac catheterization procedures. Some of these devices are deployed external to the artery, but at least one device, Angio-SealA (Sherwood, Davis & Geck), includes a polymer anchor that is deployed inside the artery. Major complications may arise from the use of this device, including thrombosis, embolization of the anchor, and infection. The manufacturer does not claim that the device reduces the incidence of local complications as compared to the traditional technique of manual compression. The author presents a case of infection of the groin involving the Angio-Seal device in which the patient presented with septic shock and renal failure after cardiac catheterization. A large abscess was present, and removal of the device required arterial surgery in an infected field. The author reports on the technique and precautions used to surgically remove the device and to prevent further complications.