ABSTRACT
A winking coronary sign refers to the partial collapse of an artery situated over the ventricular septal rupture during systole and refilling of the same during diastole, which is seen as phasic filling and disappearance of the arterial segment during coronary angiography. In this article, we discuss the case of a patient who reported to the emergency department of a tertiary care hospital in central India with myocardial infarction of the anterior wall. Two-dimensional echocardiography and coronary angiography revealed ventricular septal rupture. The patient was promptly managed by a percutaneous coronary angiography and interventricular septal device closure. Even after the defect closure, the winking coronary sign persisted on coronary angiography, and the patient was then discharged in stable condition.
ABSTRACT
The placement of a central venous catheter (CVC) is a common intervention in hospitalized patients. Several adverse events have been reported in this "blind" procedure when it is performed without the aid of ultrasound, including artery catheterization, which although uncommon, is a serious complication. Potential treatment options include manual compression, open surgical repair, and endovascular treatment. A 62-year-old critically ill patient with accidental arterial catheterization of the right common carotid artery (CCA) during placement of CVC is presented. The catheter was removed successfully with the use of a Perclose-ProGlide closure device. A systematic literature review was performed to identify similar cases treated with the same technique. This case presents an alternative minimally invasive treatment option, using a Perclose Proglide (Abbott) closure device for the removal of a misplaced CVC in the right CCA. Although this is an off-label use of the device it can be an effective alternative treatment option, especially in unstable patients.
ABSTRACT
Percutaneous arterial closure devices allow earlier mobilization and discharge of patients after arterial catheterization than manual compression for achieving puncture site hemostasis. Our case is representative of Perclose(r) associated infections; our patient had a delayed presentation of a staphylococcal arterial infection that required arterial debridement and reconstruction. Physicians should be aware of this uncommon, but serious complication to expedite the evaluation and treatment of patients with suspected infections that can arise from using these devices.
