K.H.HUANG1, L.M.LOY1, K.S.LEOW1, W.L.LEE2, U.PUA1
Tan Tock Seng Hospital1, National University of Singapore2
This retrospective study investigates the effectiveness of using Ultrasound (US) – guidance to reduce complication rates in antegrade vascular closure with the Angio-seal closure device during lower limb angioplasty.
Over the period December 2016 till December 2020, consecutive patients at our institution who underwent lower limb angioplasty with antegrade closure using Angio-seal were identified. Patients were selected by filtering our radiology reporting database using the procedure code for “angioplasty”. Data on patients’ demographics, the type of intervention, Angio-seal sheath size, haemostasis status and complications were collected. Major complications were defined as those that required open surgical intervention. Categorical variables were compared using Fisher’s exact probability test and Pearson’s Chi-square test as appropriate. A p-value of less than 0.05 was considered to be statistically significant.
Overall, 884 patients with mean age 67.0 ± 10.3 years, 615 (70%) males, underwent lower limb angioplasty using Angio-seal vascular closure device via antegrade approach. 689 (78%) patients had US-guided closure. Angioseal size 6F was used in 879 (99%) of the cases. Major complications occurred in 4 of the 195 patients (2%) with non-US guided closure compared to 2 of the 689 patients (0.3%) with US-guided closure (p=0.024). Overall complications occurred in 13 (7%) of the patients with non-US guided closure compared to 26 (4%) of the patients with US-guided closure (p=0.082).
The use of US-guidance was effective in reducing major complications requiring open surgical intervention in lower limb angioplasty patients who underwent antegrade Angio-seal closure.