Stroke and pulmonary embolism following manual and bandage compression after bleeding from a common femoral artery access site

Manual compression (MC) is required to seal a common femoral artery (CFA) access site after endovascular intervention unless a mechanical closure device is used. Herein we report previously unpublished complications following MC of a CFA access site: stroke (embolism through a patent foramen ovale) and pulmonary embolism. These were a T thrombosis of the internal carotid artery combined with multi pulmonary embolisms and a case of pulmonary embolism. No thrombophilic conditions or other possible causes of venous emboli could be demonstrated in either case by laboratory tests or color-Duplex ultrasound. These were the only two cases of pulmonary and cerebral embolism seen at our university tertiary referral center, over a five-year period. This short report considers the potential risk factors as well as a prevention policy for these complications.