angioseal
...llagen sponge, which dissolve within 60 to 90 days. How does the Angio-Seal device work? The Angio-Seal device is made of 3 absorbable components: a collagen sponge, small anchor and suture. The anchor is placed into the artery through a small delivery system where it is pulled against the inside wall of the artery to seal the puncture. The anchor and collagen are drawn together with the suture to form a secure seal. A small plastic tube is used to maintain consistent pressure on the collagen sponge and is then removed 20 minutes later. A sterile dressing is then applied to the site. Illustration The Angio-Seal device anchor (which is pointed out as A) and collagen sponge (which is B) are drawn together with a suture. A small plastic tube and metal tension spring are used to maintain consistent pressure, closing the hole and securing the seal in the artery. The absorbable suture is then cut at skin level. The suture, still attached to the anchor and collagen sponge, retracts below the skin surface and allows the healing process to begin. What are the indications? The Angio-Seal device is indicated for use in closing the puncture in the femoral artery instead of using manual or mechanical compression in patients who have undergone diagnostic angiography procedures or interventional procedures. You’ll commonly see the application of a clamping device or even weight by hand used to stop bleeding. But these methods are slow and can be very uncomfortable for the patient. These methods also require at least 15 minutes of pressure followed by 4 to 8 hours of lying flat in bed without moving the affected leg. However, patients report that the Angio-Seal device is way more comfortable. The Angio-Seal procedure itself takes a fraction of the time, and the bleeding stops much more quickly with little or no manual compression. This device also allows patients who have undergone angiograms, angioplasty or stent insertion to ambulate safely as soon as possible after the procedure and device placement. What are the contraindications? There aren’t any contraindications to the use of this device. But there are warnings and precautions to be aware of. What are the warnings? The Angio-Seal device mustn’t be used where bacteria may have contaminated the procedure sheath or surrounding tissues as this may result in an infection. The device also shouldn’t be used if the puncture site is proximal to the inguinal ligament as this may result in a retroperitoneal hematoma, so that’s a mass of usually clotted blood that forms behind the serous membrane lining the abdominal cavity. What are the precautions? The safety and effectiveness of the Angio-Seal device has not been established in: · Patients who have known allergies to absorbable suture, beef products and/or collagen products. · Patients with pre-existing autoimmune disease. · Patients with clinically significant circulation problems like peripheral vascular disease. · Patients with uncontrolled hypertension, so those who have a systolic BP >180. · Patients with a bleeding disorder, including thrombocytopenia (<100,000 platelet count) or anemia (Hgb<10 mg/dl, Hct<30). · Pediatric patients or others with small femoral artery size, so that’s <4 mm in diameter. That’s because a small femoral artery size may prevent the Angio-Seal anchor from being placed properly in these patients. · Patients who are pregnant or lactating. So it hasn’t been proven to be effective and safe in these patient populations. So as a nurse, you should be detailed in your assessment when admitting patients and checking their medical history because the physician may elect to use the Angio-Seal device. And if the patients have any of the previous conditions I’ve mentioned, then the nurse should make a note on their charts, so that the Angio-Seal won’t be used in their case. Potential Adverse Events The possible adverse events for this device include, but are not limited to bleeding or hematoma and pseudoaneurysm (so that’s a false aneurysm meaning that there’s a disruption of all layers of the arterial wall resulting in bleeding that’s contained by surrounding structures). Other adverse effects of an Angio-Seal that may result are infection, allergic reaction, foreign body reaction, inflammation or edema. Post-Catheterization Patient Care Instructions · As for the post-catheterization patient care instructions, the nurse reviews the purpose and description of the Angio-Seal device. · Illustrations of the device are provided. · You also need to instruct the patient not to have the artery repunctured in the same area for 90 days. · You also provide the patients with an information card that they are to carry around with them in their wallet for the next 90 days, so that if they are to have another procedure done within the 90 days of this one, the physician i...