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Case report with Angio-Seal VIP

​Introducing the patient

Information on the patient

  • 33 years old, male
  • No risk factors for CAD/PAD
  • History: active lifestyle, no history of previous diseases
  • Current presentation: hypotonia (left side of the body)
  • Starting angiography/echo doppler/test results:
    • Head and neck CT showed occlusion of the right middle cerebral artery (MCA: M1 segment), with NIHSS 10
    • R-tPA thrombolytic therapy was administered

Procedure

Procedural Steps

  • While still on thrombolytic therapy, patient was brought to the cath lab.
  • Using femoral access, standard telescopic (catheter -microcatheter) technique was used to reach the targeted artery.
  • Digital subtraction angiography (DSA) confirmed occlusion in M1 segment of the MCA.
  • Successful thrombectomy using clot retrieval device was performed. Thrombolytic therapy elapsed during the thrombectomy procedure.
  • At the end of the procedure, the access site was successfully closed with closure device.

Materials used: based on previous very positive experience

  • Radifocus Introducer II 6Fr (Terumo)
  • Sofia catheter (MicroVention)
  • Radifocus Guide Wire M 0.035” (Terumo)
  • Rebar microcatheter (Medtronic)
  • Chikai 0.014” (Asahi)
  • Solitaire Platinum 4x20mm (Medtronic)
  • Angio-Seal VIP Vascular Closure Device 6Fr (Terumo)

Procedural challenges

  • No

What happened to the patient

What were the immediate outcomes after the procedure?

  • Complete revascularisation was achieved

Were there any complications? Were symptoms resolved? Was the patient healthy and able to ambulate (time to ambulation / to discharge)?

  • There were no complications, patient was discharged from the hospital following standard hospital practice, 3 days after the procedure.

Any tips and tricks to share on the vascular closure device?

  • The patients on thrombolytic therapy are considered as patients with high risk for extended bleeding, where manual access site compression could be challenging both from the patient’s safety and organizational prospective (nursing time).
  • By using Angio-Seal VIP Vascular Closure Device 6Fr we managed to maintain a steady patient flow in the cath lab.
  • Our 6 year-long experience with more than 8 % of patients on thrombolytic therapy treated proved this approach as very effective.



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