Infection is an Unusual But Serious Complication of a Femoral Artery Catheterization Site Closure Device Gregory S. Cherr, MD, 1 Jeffrey A. Travis, MD, 1 John Ligush, Jr, MD, 1 George Plonk, MD, 1 Kimberley J. Hansen, MD, 1 Gregory Braden, MD, 2 and Randolph L. Geary, MD, 1 Winston-Salem, North Carolina Percutaneous devices have been developed to close the femoral artery puncture site after catheterization. Because direct compression is not needed, the devices save time for the treat- ing health-care provider, reduce patient discomfort, and obviate the need for post-catheterization bed rest. Reported complications with use of these devices are similar in nature and frequency to those accompanying direct compression. Complications of infection requiring surgical treat- ment are exceedingly rare with use of these devices. We describe a series of five catheterization site infections occurring among 1807 patients (0.3%) whose femoral artery puncture was closed with a percutaneous suture closure device. All patients required operative intervention and there was one late death. Physicians should be aware of this uncommon but serious complication to expedite evaluation and treatment of patients with suspected infections from these devices. For patients undergoing arteriography, the femoral artery catheterization site is a potential source of complications. After removal of the femoral artery sheath, standard treatment is manual compression followed by bed rest. Manual compression is time consuming for the health-care provider and painful for the patient. Mechanical compression (C-arm clamp or pneumatic compression device) followed by bed rest saves time for the health-care provider but does not reduce patient discomfort. 1 As an al- ternative to manual compression, percutaneous closure devices for the femoral artery catheteriza- tion site have been developed. One of these devices, in which suture is used to close the arterial punc- ture site, has recently been employed in our insti- tution (Perclose, Inc., Redwood City, CA). In the Perclose device, 3-0 braided polyester su- ture is used to close the artery wall. For smaller femoral access sheaths, a 6 French Perclose device delivers one suture, while an 8 French Perclose de- vice uses two sutures to close larger arterial punc- ture sites. Compared to manual or mechanical com- pression, this device is reported to reduce patient discomfort, time to hemostasis, and health-care provider inconvenience with no increase in the rate of complications. 2-9 Because the suture achieves immediate hemostasis, patients can be mobilized earlier, resulting in shorter hospital stays and re- duced costs. 4-10 Published reports describing large series of patients undergoing Perclose device place- ment do not describe infections requiring operative management. 2-15 During a recent 12-month period, the Perclose device was used for hemostasis of the femoral ar- tery in 1807 patients after cardiac catheterization at 1 Department of General Surgery, Section on Vascular Surgery, Wake Forest University School of Medicine, Winston-Salem, NC. 2 Department of Internal Medicine, Section on Cardiology, Wake For- est University School of Medicine, Winston-Salem, NC. Correspondence to: R.L. Geary, MD, FACS, Associate Professor of Surgery and Pathology, Division of Surgical Sciences, Wake Forest Uni- versity School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA, E-mail: rgeary@wfubmc.edu. Ann Vasc Surg 2001; 15: 567-570 DOI: 10.1007/s10016-001-0002-2 © Annals of Vascular Surgery Inc. Published online: August 23, 2001 567