Sun LX, Yang XS, Zhang DW, Zhao B, Li LL, Zhang Q, Hao QZ. Flip-over of blood vessel intima caused by vascular closure device: A case report. World J Clin Cases 2022; 10(7): 2247-2252 [PMID: 35321181 DOI: 10.12998/wjcc.v10.i7.2247]
Corresponding Author of This Article
Qing-Zhi Hao, MD, Professor, Department of Peripheral Vascular Diseases, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, No. 16369 Shanshi East Road, Jingshi Road, Lixia District, Jinan 250000, Shandong Province, China. haodoctor2@126.com
Research Domain of This Article
Peripheral Vascular Disease
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Li-Xia Sun, Lian-Lian Li, Qi Zhang, The First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan 250000, Shandong Province, China
Xue-Song Yang, Da-Wei Zhang, Bo Zhao, Qing-Zhi Hao, Department of Peripheral Vascular Diseases, the Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250000, Shandong Province, China
Author contributions: Hao QZ designed the study and collected the fund; Sun LX, Yang XS, Zhang DW, and Zhao B collected the case, analyzed the data; Li LL and Zhang Q searched the literatures; and Sun LX wrote the manuscript.
Supported bythe Traditional Chinese Medicine Science, No. 2017-057, 2017-058 and 2019-0969; and Technology Development Project of Shandong Province, No. 2019-0971.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2013), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Qing-Zhi Hao, MD, Professor, Department of Peripheral Vascular Diseases, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, No. 16369 Shanshi East Road, Jingshi Road, Lixia District, Jinan 250000, Shandong Province, China. haodoctor2@126.com
Received: July 9, 2021 Peer-review started: July 9, 2021 First decision: October 22, 2021 Revised: November 3, 2021 Accepted: January 22, 2022 Article in press: January 22, 2022 Published online: March 6, 2022 Processing time: 235 Days and 20.3 Hours
Abstract
BACKGROUND
Complications of vascular closure devices mainly include bleeding, vascular injury, and trapped device that cannot be removed percutaneously. However, arterial stenosis or occlusion induced by vascular injury is rare. This article introduces a rare case with severe acute limb ischemia after using the vascular closure device (StarClose).
CASE SUMMARY
A 54-year-old man was admitted because of necrosis of the second toe of the left foot for 2 mo. Ultrasound showed left femoral artery stenosis, and occlusion of the left popliteal, posterior tibial, peroneal, anterior tibial and dorsalis pedis arteries, suggesting arteriosclerosis obliterans of low extremities, gangrene and type 2 diabetes. He underwent an interventional procedure of drug-eluting balloon in the left lower limb via antegrade puncture of the left common femoral artery. He developed acute limb ischemia after 1 h, and severe pain, numbness, pale skin, low skin temperature and weakened sensation in the left foot. Injury of the common femoral artery intima was considered. Exploratory surgery showed occlusion at the puncture point accompanied with bulged vascular lumen and flipped vascular intima caused by StarClose. The flipped intima was removed. The limb blood supply was restored and the limb was saved post-surgery. He recovered well at final follow-up.
CONCLUSION
Incorrect use of the vascular closure device was the main cause of severe acute limb ischemia in this case.
Core Tip: Clinical reports on the complications of vascular injury caused by vascular closure devices are rare. Here, we report a case of severe acute limb ischemia after using a vascular closure device (StarClose). The case suggests that use of the vascular closure device was the main cause of severe acute limb ischemia in this case. The vascular closure device should be operated carefully.
