Rapid hemostasis of the residual inguinal access sites during endovascular procedures: A case report

BACKGROUND: In endovascular procedures including total percutaneous endovascular aneurysm repair (pEVAR), percutaneous access through the common femoral artery is most commonly performed. Access-site bleeding is a major concern in percutaneous techniques. Herein, we present a case of successful control of continuous oozing using a vascular closure device (VCD) and the application of Surgicel (Johnson & Johnson, United States) over the access tract. CASE SUMMARY: An 82-year-old man presented with an unruptured abdominal aortic aneurysm measuring 83 mm × 75 mm. The patient had a medical history of atrial fibrillation and was receiving rivaroxaban (15 mg/d). Routine pEVAR was performed using the preclose technique with ProGlide (Abbott, Santa Clara, CA, United States). Significant amount of bleeding was observed at the end of the procedure after the deployment of the closure device at the access site. A sheet of Surgicel was applied to the suture thread using a surgical needle. Surgicel was applied to the surface of the artery along the access tract using a pusher, and hemostasis was immediately attained. CONCLUSION: This simple technique is an excellent adjunct to control residual bleeding from the access site following VCD use.