{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:19:35Z","timestamp":1790036375570,"version":"4.0.1"},"reference-count":30,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T00:00:00Z","timestamp":1766361600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: Emergency arterial embolization is a life-saving procedure typically performed via femoral access. This study evaluated the safety and efficacy of immediate femoral sheath removal following emergency embolization. Methods: A retrospective cohort study was conducted at a Level 1 trauma center (January 2022\u2013May 2025). Adult patients undergoing emergency embolization with immediate sheath removal were included. Endpoints were reintervention (repeat embolization within 7 days) and access site complications. Multivariate logistic regression identified independent predictors of outcomes. Results: A total of 322 emergency embolization procedures in 299 patients were included. The most common indication was gastrointestinal hemorrhage (45.7%). Vascular closure devices (VCDs) were used in 92.5% of cases. The re-intervention rate was 4.0% (13\/322). The overall access site complication rate was 6.2% (20\/322), with a major complication rate of 0.9% (3\/322). On univariate analysis, pre-procedural platelet level \u2264 80 \u00d7 109\/L (p = 0.034) and INR &gt; 1.5 (p = 0.034) were significantly associated with an increased risk of complications. On multivariate analysis, pre-procedural platelets \u2264 80 \u00d7 109\/L was the strongest independent predictor of access site complications (OR 7.28, 95% CI 1.51\u201335.12; p = 0.013). Choice of vascular closure device was an independent predictor for both reintervention and complications (p &lt; 0.05), likely reflecting bias. Conclusions: Immediate femoral sheath removal following emergency embolization is safe for most patients. However, thrombocytopenia is a significant risk factor for access site complications. A risk-stratified approach with consideration for delayed sheath removal is warranted for patients with platelet counts \u2264 80 \u00d7 109\/L.<\/jats:p>","DOI":"10.3390\/diagnostics16010040","type":"journal-article","created":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T16:19:26Z","timestamp":1766420366000},"page":"40","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Real-World Outcomes of Immediate Femoral Sheath Removal After Emergency Embolization in the Age of Ultrasound-Guided Device-Assisted Vascular Closure"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6941-4442","authenticated-orcid":false,"given":"Terrence","family":"Hui","sequence":"first","affiliation":[{"name":"Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore 308433, Singapore"},{"name":"Department of Interventional Radiology, Liverpool Hospital, Liverpool, NSW 2170, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3050-5555","authenticated-orcid":false,"given":"Akshay","family":"Kohli","sequence":"additional","affiliation":[{"name":"Department of Interventional Radiology, Liverpool Hospital, Liverpool, NSW 2170, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9692-7502","authenticated-orcid":false,"given":"Ross","family":"Copping","sequence":"additional","affiliation":[{"name":"Department of Interventional Radiology, Liverpool Hospital, Liverpool, NSW 2170, Australia"},{"name":"Discipline of Medicine, UNSW Medicine and Health, Sydney, NSW 2052, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Ireland","sequence":"additional","affiliation":[{"name":"Department of Interventional Radiology, Liverpool Hospital, Liverpool, NSW 2170, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shady","family":"Osman","sequence":"additional","affiliation":[{"name":"Department of Interventional Radiology, Liverpool Hospital, Liverpool, NSW 2170, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryan","family":"Barry","sequence":"additional","affiliation":[{"name":"Department of Interventional Radiology, Liverpool Hospital, Liverpool, NSW 2170, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jules","family":"Catt","sequence":"additional","affiliation":[{"name":"Department of Interventional Radiology, Liverpool Hospital, Liverpool, NSW 2170, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Glen","family":"Schlaphoff","sequence":"additional","affiliation":[{"name":"Department of Interventional Radiology, Liverpool Hospital, Liverpool, NSW 2170, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1186\/s42155-024-00485-z","article-title":"Damage Control Interventional Radiology: The bridge between non-operative management and damage control surgery","volume":"7","author":"Ascenti","year":"2024","journal-title":"CVIR Endovasc."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1055\/s-0041-1725114","article-title":"Where Does Interventional Radiology Fit in with Trauma Management Algorithm?","volume":"38","author":"Pillai","year":"2021","journal-title":"Semin. 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