Published online Mar 6, 2022. doi: 10.12998/wjcc.v10.i7.2247
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
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).
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.
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.