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     Jean,

     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 _________________________________
Subject: angio-seal
Author:  UVM Flownet <[log in to unmask]> at Internet-Mail
Date:    9/2/99 7:43 PM


Hello Flownetters,

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.

Thank you
Jean Perdue RN RVT