TM FemoStop Femoral Compression System for Ultrasound-Guided Compression Repair (UGCR) of Femoral Pseudoaneurysm Module Contents 2 Pseudoaneurysm Proven to Reduce Complications Treatment of Pseudoaneurysm Early Treatment Principle of Compression Repair FemoStop Positioning Applying pressure Factors Affecting Success Summary Pseudoaneurysm False aneurysm Extravascular cavity, pseudoaneurysm sac Presence of flow Not contained by vessel wall Pseudoaneurysm sac Communicating (feeding) tract 3 Proven to Reduce Complications¹,² FemoStop reduces vascular complications following sheath removal FemoStop helps prevent femoral artery pseudoaneurysm 1. 2. 4 Sridhar K, Fischman D, Goldberg S, et al. Peripheral vascular complications after intracoronary stent placement: prevention by use of a pneumatic vascular compression device. Cathet Cardiovasc Diagn. 1996:39(3):224-229. Amin F, Yousufuddin M, Stables R, et al. Femoral haemostasis after transcatheter therapeutic intervention: a prospective randomised study of the angio-seal device vs. the femostop device. Intl J of Cardiol. 2000;76(2-3):235-40. Treatment of Pseudoaneurysm Treatment by ultrasound-guided compression repair of femoral artery pseudoaneurysms is an Indication for Use in the U.S. 5 Early Treatment By using FemoStop, compression can be initiated early on the ward, while waiting for duplex ultrasonogram 6 Principle of Compression Repair Pseudoaneurysm sac PRESSURE Communicating (feeding) tract 7 PRESSURE Using FemoStop for UGCR 1. Premedication 2. Baseline blood pressure, distal pulses 3. Ultrasound 4. Demarcate compression site 5. Position FemoStop 6. 20 min. compression; distal pulses 7. Release pressure 8. Ultrasound 9. Repeat steps 6-8 if necessary 10. Light compression and bed rest 11. Ultrasound * 8 FemoStop Positioning Vein Pseudoaneurysm Artery 9 FemoStop Positioning Sterile tape may be used to demarcate the compression site as determined by ultrasound 10 FemoStop Positioning Apply until ultrasound is available: Pressure on arterial puncture (not skin incision). PRESSURE Skin incision Skin Artery Arterial sheath 11 Arterial puncture Applying Pressure Apply enough pressure to minimize arterial blood flow but: Do not obliterate flow in the artery itself Do not compress the vein, if possible Do not make compression unbearable for the patient (i.e., 20 mmHg below the patient’s systolic blood pressure) 12 Applying Pressure PRESSURE Pseudoaneurysm sac 13 PRESSURE Patient’s arterial lumen Pressure Duration Compression time Up to 300 minutes (in cycles of 20 minutes) Mean compression time approximately 40 minutes 14 Pressure Duration Short compression cycles (20 min*): Prevent vessel thrombosis Prevent nerve injury Prevent skin abrasion/necrosis *Chatterjee J, et al. Catheter Cardiovasc Interv. 1999;47:304-9. 15 Factors Affecting Success Ability to compress Anticoagulation status Pseudoaneurysm size PRESSURE Patient’s arterial lumen 16 Factors Affecting Success Ability to compress Anticoagulation status Pseudoaneurysm size One or more compartments Age of the pseudoaneurysm (epithelialization of the tract and more fibrous capsule) Neck width Short feeding tract <10 mm 17 Summary FemoStop: Helps prevent pseudoaneurysms in the first place UGCR method is relatively easy Makes UGCR a NON-labor-intensive method of treatment A ”first line” treatment to help prevent further development of a bleeding complication 18 Rx Only Please review the Instructions for Use prior to using these devices for a complete listing of indications, contraindications, warnings, precautions, potential adverse events and directions for use. Product referenced is approved for CE Mark. FemoStop is designed, developed and manufactured by St. Jude Medical Systems AB. FemoStop, RADI, ST. JUDE MEDICAL, the nine-squares symbol and MORE CONTROL. LESS RISK. are registered and unregistered trademarks and service marks of St. Jude Medical, Inc. and its related companies. ©2011 St. Jude Medical, Inc. All rights reserved. IPN 1691-11 19