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Giovanni Solimeno: When the Common Femoral Artery Wall is Diseased, Closure is Not a Step
Giovanni Solimeno/ LinkedIn
May 10, 2026, 18:05

Giovanni Solimeno: When the Common Femoral Artery Wall is Diseased, Closure is Not a Step

Giovanni Solimeno, Vascular and Endovascular Surgeon at Pineta Grande Hospital, shared a post on LinkedIn:

“When the Common Femoral Artery wall is diseased, closure is not a step — it’s a part of the endovascular access strategy.

We all love fast hemostasis.

But there’s one scenario where a ‘standard’ closure can become a trap:

a patent, non-critical CFA… with a truly diseased wall.

Here’s the mechanism (simple, but easy to underestimate):

If you deploy a closure system that relies on proper wall apposition, and the device lands on a plaque, tension can be imperfect so the intraluminal component may end up malapposed.

And then two things can happen:

  1. Incomplete hemostasis is usually manageable with compression.
  2. The real problem: an intraluminal foreign body and disturbed flow can increase the risk of acute thrombosis/occlusion in a vessel you absolutely don’t want to lose.

So my practical rule is simple, but non-negotiable:

  • US-guided puncture – always. Find the healthiest CFA segment.
  • If the wall is hostile and I can’t guarantee a safe landing zone, I’m happy to compress, or I choose a strategy that doesn’t leave anything intraluminal.
  • Closure is not ‘after the case’. It’s part of the case.

How do you handle closure in a calcified / diseased CFA? Any personal red flags?”

Giovanni Solimeno: When the Common Femoral Artery Wall is Diseased, Closure is Not a Step

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