In recent years, there has been a shift from the inguinal approach to coronary artery treatment to the radial approach, which has fewer complications. However, the inguinal approach is still often used in cases of dialysis. Following inguinal puncture, vascular closure devices (VCDs) such as ANGIO-SEAL® (Terumo, Tokyo, Japan), EXOSEAL® (Hialeah, Miami Lakes, FL), and Perclose ProGlide® (Abbott Vascular Device, Santa Clara, CA) are used according to their various characteristics. In this report, a 61-year-old male patient supported by maintenance dialysis underwent a medical examination, whereupon an abnormal electrocardiogram was produced. When a catheter was then implemented, three-vessel disease was found, and coronary artery bypass grafting (CABG) was recommended. However, upon the patient’s request, percutaneous coronary transluminal angioplasty (PTCA) was instead performed. The patient underwent coronary artery treatment across three sessions; in the third session, an approach from the right inguinal region was taken, and Perclose ProGlide® was used for vascular closure following treatment. However, paralysis of the right lower limb occurred four days later, and the patient returned to our department, where he was found to have high inflammation levels, methicillin-susceptible Staphylococcus aureus (MSSA) in a blood culture, and a pseudoaneurysm in the right inguinal region as indicated by a computed tomography (CT) scan. Thus, the patient was diagnosed with an infectious pseudoaneurysm and transferred to another hospital for surgical treatment. Here, we report on a case of an infectious pseudoaneurysm that required surgery with a vascular closure device.
Imamura et al. (Tue,) studied this question.