The Critical Role of Ultrasound in Diagnosing Complete Intra-Arterial Misplacement of an Angio-Seal Closure Device: A Case Report

Introduction

Vascular closure devices (VCDs) have revolutionized post-procedural hemostasis following arterial catheterization by providing a faster and more efficient alternative to traditional manual compression. However, complications such as misplacement or malfunction can result in arterial thrombosis, pseudoaneurysm, or occlusion, which require early diagnosis and management to prevent morbidity (V.J. Noori et al. J Vasc Surg 2018; 68: 887–899).

Ultrasound is an indispensable, non-invasive tool for diagnosing and managing vascular complications. With its ability to provide real-time imaging and high-resolution visualization, it is uniquely positioned as the first-line diagnostic modality for evaluating VCD-related issues. Furthermore, the use of Doppler techniques enables precise assessment of blood flow dynamics, eliminating the need for more invasive imaging modalities like CT angiography and MRI in many cases (M.A. Entremont et al. EuroIntervention 2023; 15: 73–79).

This case underscores the critical role of ultrasound in diagnosing a rare and severe complication of VCD misplacement. In this instance, the device was fully deployed intra-arterially, resulting in complete thrombosis of the superficial femoral artery. The precise imaging provided by ultrasound allowed for detailed visualization of the misplaced device and the accompanying thrombotic occlusion, highlighting its indispensable value as a diagnostic tool in vascular medicine.

Publication History

Received: 18 January 2025

Accepted after revision: 26 August 2025

Article published online:
02 October 2025