止血デバイス使用後の合併症診断に超音波検査が有用であった1例

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  • A Case of Useful Application of Duplex Ultrasound Scanning for Diagnosis of Vascular Occupying Complication after Using the Vascular Closure Device

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<p>Vascular closure devices (VCDs) are frequently used at the puncture site after percutaneous intervention procedures for reduced the time for hemostasis and immobilization, and shortened hospital stay. We report on a case of duplex ultrasound scanning (DUS) was useful in diagnosis of complication after deployment of the VCD.</p><p>An 80s-year-old female had been subjected to a percutaneous coronary intervention (PCI) via her right common femoral artery (CFA). At the end of the uncomplicated procedure, the puncture site was closed using an Angio-Seal™ (St. Jude Medical) device. The next day, routine physical examination of the puncture site revealed a systolic murmur over her right groin. DUS showed a stenotic lesion due to a structure of an isoechoic mass with suture-like tale. We thought that the structure was an Angio-Seal™ device that was intraluminal misplaced.</p><p>After PCI procedure, the ankle brachial index (ABI) value on the right side decreased from 0.84 to 0.60. But she had no symptoms in her lower limb, so she was discharged home.</p><p>Approximately 4 weeks after the PCI procedure, she was admitted to our hospital with coldness and claudication of her right leg. DUS showed an occluded lesion in the right CFA. Angiography revealed total occlusion in right CFA the same as DUS. Endovascular treatment (EVT) was performed. There was a good angiographic result with no significant stenosis at the end of procedure.</p><p>At follow up, the patient had no symptoms and complications in her right leg.</p><p>After VCD deployment, DUS of the puncture site is useful for early detection complications and prediction of delayed complications such as arterial occlusion.</p>

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  • 超音波検査技術

    超音波検査技術 42 (2), 186-192, 2017

    一般社団法人 日本超音波検査学会

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