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Mark R. Nehler, MD, W. Andrew Lawrence, MD, Thomas A

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Presentation on theme: "Mark R. Nehler, MD, W. Andrew Lawrence, MD, Thomas A"— Presentation transcript:

1 Iatrogenic vascular injuries from percutaneous vascular suturing devices 
Mark R. Nehler, MD, W.Andrew Lawrence, MD, Thomas A. Whitehill, MD, Scott D. Charette, MD, Darrell N. Jones, PhD, William C. Krupski, MD  Journal of Vascular Surgery  Volume 33, Issue 5, Pages (May 2001) DOI: /mva Copyright © 2001 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

2 Fig. 1 Wide exposure of femoral bifurcation to remove entrapped Prostar device. Journal of Vascular Surgery  , DOI: ( /mva ) Copyright © 2001 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

3 Fig. 2 Posterior wall intimal injury (arrow ) of common femoral artery caused during deployment of foot portion of Closer device. Journal of Vascular Surgery  , DOI: ( /mva ) Copyright © 2001 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

4 Fig. 3 Prostar/Techstar device for percutaneous suturing. Both devices are of the same design and differ in French size only (6F vs 8F). A, The barrel of device demonstrated through subcutaneous tissue and in contact with artery wall. The needles (small solid arrows ) are deployed from within the lumen to enter introducer device outside the wall (B). This has the potential for needle misalignment if the needle sheath is not correctly aligned with introducer. C, Suture is pulled through device, and an extracorporeal knot is tied. Journal of Vascular Surgery  , DOI: ( /mva ) Copyright © 2001 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

5 Fig. 4 Closer device for percutaneous suturing. A, Global view of device. Guide and angle of deployment area are rigid to help prevent misapplication of sutures. B, Device inside arterial lumen showing the foot deployed by moving the lever. The plunger is used to deploy needles that traverse arterial wall. C, Closeup of foot device deployed that helps guide needles to suture. Stainless steel needles come from ports above and travel from outside the artery to within. The foot device is rigid and within the artery and can potentially damage posterior intima if artery is small and device deployed too deep posteriorly within the vessel. Journal of Vascular Surgery  , DOI: ( /mva ) Copyright © 2001 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

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