We have seen a few of these cases, too. The velocities have always
been 300+ cm/s. Often times we can't really see anything on the
B-mode image but the Doppler and color clearly demonstrate turbulence
and the increased velocity. We try to document signals above the
stenosis, at the stenosis and distal to the stenosis. We also do a
quick recording of the femoral vein - just to document it's patency.
One other thing besides a stenosis that we have observed is a strange
type of pseudoaneurysm. A couple of patients who had angio-seals used
had a leak out of the artery. It was enclosed or saccular in any way
like most pseudoaneurysms but rather just flow leaking out of the
artery. All these patients required surgical repair. Sometimes the
angio-seal devise was still in the artery and sometimes it was
floating around outside of the vessel.
Ann Marie Kupinski
______________________________ Reply Separator _________________________________
Author: UVM Flownet <[log in to unmask]> at Internet-Mail
Date: 9/2/99 7:43 PM
I would like to request some advice on this interesting case.
Although I have been 'lurking' for some time this is my first posting.
Today I was called to the PACU for a cardiac cath patient with diminished
foot pulses. 'Angio-seal' had been used. This is new to my facility with
only 50 or so patients being done so far.
On duplex I saw a flow restricting foreign body in the CFA.
The velocity was approx 500 cm/s at restriction with post turbulence
This foreign body was presumed to be the collagen from the angio seal.
Patient was taken to OR for 'foreign body' removal and did well.
Has anybody had experience with this complication?? I would appreciate
advice on what images are most useful and how this is treated at other places.
Jean Perdue RN RVT