Name of the Procedure:

Common Name(s): Placement of occlusive device, vascular plug, AngioSeal plug insertion.
Medical Term: Occlusive device insertion for venous or arterial access site closure.

Summary

This procedure involves placing an occlusive device, such as an AngioSeal or vascular plug, into a venous or arterial access site to prevent bleeding after a surgical or interventional procedure.

Purpose

Medical Conditions/Problems Addressed:

• Prevention of bleeding at the access site.
• Closure of venous or arterial puncture sites.

Goals/Outcomes:

• Immediate hemostasis (cessation of bleeding) at the access site.
• Reduced recovery time and complications related to site bleeding.

Indications

Symptoms/Conditions:

• Post-angiogram or other catheter-based interventional procedures.
• High risk of bleeding from the access site post-procedure.

Patient Criteria:

• Patients who have undergone a surgical or interventional procedure that required venous or arterial access.
• Patients requiring quick mobilization post-procedure.

Preparation

Pre-procedure Instructions:

• Patients may need to fast for a few hours if conscious sedation is planned.
• Follow instructions about medication adjustments, particularly blood thinners.

Diagnostic Tests/Assessments:

• Blood tests to assess clotting ability.
• Imaging studies to confirm access site and vessel anatomy.

Procedure Description

Steps Involved:

1. The access site used for the initial procedure is cleaned and prepared.
2. A guidewire is reinserted into the access site.
3. The occlusive device delivery system is advanced over the guidewire to the access site.
4. The occlusive device (e.g., AngioSeal plug, vascular plug) is deployed to seal the vessel puncture.
5. The delivery system and guidewire are removed, and the site is checked for bleeding.

Tools/Equipment:

• Guidewire, occlusive device system (e.g., AngioSeal kit).

Anesthesia/Sedation:

• Local anesthesia to numb the area may be used.
• Conscious sedation if the patient experiences discomfort.

Duration

The procedure typically takes around 15 to 30 minutes.

Setting

Usually performed in a hospital, outpatient clinic, or surgical center.

Personnel

• Interventional radiologist or vascular surgeon.
• Nurses and possibly an anesthesiologist or nurse anesthetist.

Risks and Complications

Common Risks:

• Minor bleeding at the site.
• Pain or discomfort.

Rare Risks:

• Infection.
• Vascular complications such as diminished blood flow to the limb.
• Device malfunction or displacement.

Benefits

• Quick and effective closure of the access site.
• Reduced bleeding risk.
• Faster recovery and mobilization.
• Lower overall complication rates compared to manual compression.

Recovery

Post-procedure Care:

• Monitoring for signs of bleeding or complications.

• Keeping the site clean and dry.

  Expected Recovery Time:

• Patients can usually resume normal activities within a day, but should avoid strenuous activities for a few days. Follow-up appointments may be necessary.

Alternatives

Other Treatment Options:

• Manual compression to achieve hemostasis.
• Sutures or alternative closure devices.

Pros and Cons:

• Manual compression is less invasive but can require longer immobilization and monitoring.
• Sutures can provide mechanical closure but may be more time-consuming and uncomfortable.

Patient Experience

During Procedure:

• Minimal discomfort with local anesthesia.
• May feel pressure or slight tugging at the site.

After Procedure:

• Mild soreness or bruising at the site.
• Pain management with over-the-counter pain relievers if needed.
• Following care instructions reduces complication risk and ensures a smooth recovery.