Elsevier

Cardiovascular Surgery

Volume 10, Issue 2, April 2002, Pages 161-163
Cardiovascular Surgery

CASE REPORT
Management of infected femoral closure devices

https://doi.org/10.1016/S0967-2109(01)00115-6Get rights and content

Abstract

An increase in infectious complications has been noted with the introduction of percutaneous femoral artery closure devices. We report five cases of infected groins and/or femoral arteries following angiographic procedures that were completed using the Perclose Suture Mediated Closure Device (Perclose). Each patient required drainage of the abscess and removal of the Perclose suture. Most patients required more extensive vascular reconstructive procedures. When these complications arise, we recommend expeditious drainage of the abscess, removal of the suture, and adequate exposure of the femoral artery to facilitate repair of the vessel.

Introduction

As more interventional cardiac and vascular procedures are performed percutaneously, devices used to facilitate closure of the puncture site to allow early ambulation and discharge have proliferated. Although these closure devices have proven effective, complications related to their use have occurred.

Five cases of infection associated with the Perclose Suture Mediated Closure device (Perclose) have recently required surgical treatment at our hospital. Each case has required incision and drainage of an abcess and repair or ligation and bypass of the femoral artery.

Section snippets

Case one

A 65-yr-old male was admitted with angina and mild ECG changes. A Perclose device was placed after coronary angiogram revealed severe, four vessel disease. Cardiothoracic surgery determined him to be a very poor operative risk. Three days later, the patient developed fevers. On the fifth post-angio day, the right femoral puncture site developed erythema and purulent discharge. The patient was started on cefazolin and taken to the operating room for wound debridement. The wound was drained of

Discussion

There have been several case reports of infected Angio-Seal (Sherwood, Davis & Geck) and Perclose closure devices that presented as groin abscesses and necessitated removal of the devices [1], [2], [3], [4]. We present the largest series of infectious complications from the Perclose percutaneous femoral closure device.

Reported infection rates with Perclose Suture Mediated Closure devices were low in clinical trials; the rate of infections treated with i.v. antibiotics was 0–0.8% and the rate

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