Angio-Seal

Last Wednesday my procedure included the insertion of a catheter into my artery in my right groin area to get access to the artery coming into my liver. When the procedure was completed the doctor closed the hole in my artery using a device known as an Angio-Seal.

This device is kind of like an anchor that you might insert into a hole in the wall when the hole is too large for a nail or a regular screw. In the case of the Angio-Seal there is an anchor that is inserted inside the artery and there is a suture that connects to the anchor which puts tension on it to close the hole. There is also a third component which is collagen which is outside the artery at the point where the suture and anchor are connected. This helps seal the hole as well.

The purpose of the device is to allow quick recovery (a couple of hours) following the procedure as compared the the traditional method of applying pressure on the artery for some time and then 6 or 7 hours of recovery to prevent the artery from bleeding again. One interesting aspect of the Angio-Seal is that all 3 components are made from a "biomaterial" which is absorbed by your body within 60-90 days.

I assume that it is all working well but this area has been sore since last week with a nice big bruise. The bruise is starting to fade a little and I am sure that the soreness is due to the procedure with the catheter in the artery as compared to the Angio-Seal applied at the end (mostly since the soreness extends higher than just the area of where the artery was sealed).

My next test is an MRI/MRA (magnetic resonance angiography) which will get a good view of my liver and the blood vessels in it to confirm that it has grown enough for the surgery. This test will be this Thursday (10/16/08) at another Northwestern Memorial location in Chicago. If the results from this are good then the surgery will be scheduled in the near future. It sounds like there will be one more trip to Northwestern before the surgery to get the pre-surgery blood tests completed once it is known exactly when the surgery will be.

10/15 Update:

I was sitting at work today and all of a sudden I had an epiphany about this Angio-Seal business. Yesterday I compared it to an anchor behind a big hole in the wall. Well this is an ok comparison but it lacks the plugging up the hole which the Angio-Seal does. The better comparison is an aluminum rivet:


A rivet is plugged into a hole with a "rivet gun" which pushes the rivet into the hole and then it pulls on the aluminum stick part (the bottom of the rivets in these pictures). This causes the top of the rivet to bulge out and between that bulge and the middle section above the hole is plugged up on both sides. The rivet gun then breaks off the "stick" part as it is no longer needed once the hole is plugged.

So in the case of the Angio-Seal it is exactly the same kind of thing happening. The only difference is that the "stick" is the suture which pulls on the anchor on the inside of the artery and the collagen covers up the other side of the hole. Like the rivet stick, the suture is cut at skin level once the Angio-Seal is in place and it pulls back below the skin level (where it is later absorbed by the body along with the other parts).

So I now have a much better understanding of why my leg is sore. I just imagine someone using a rivet gun and placing a rivet in my body. It all makes sense now... :)