We read with great interest the important article by Dwivedi et al. [1]. The author observed that the diameter of common femoral artery (CFA) increased in long-term (49.9 ± 11.1 months) scan compared with post-operative scan at 30 days. They theorize that the dilatation of CFA is due to the underlying aneurismal disease process, given age and long follow-up time.

In the study of Grandhi [2] and colleagues, 98 patients underwent 102 repeat angiograms following closure with vascular close device (VCD), 7 cases were demonstrated with minor vessel stenoses (average stenosis, 21%), and the average time to the repeat angiogram was 73.5 days. Heo et al. [3] evaluated the puncture sites by ultrasound during the median follow-up time of 187.0 days. Intimal hyperplasia was observed as hypoechoic thickening on US follow-up, which also caused a narrowed minimal luminal diameter. These results may be explained by the fact that intimal hyperplasia tends to facilitating puncture sites be stenosis in short-term and median follow-up. The mean follow-up time of Dwivedi et al. [1] is 49.9 months, more than 4 years. The patients are growing old. Aging contributes to the development of endothelial dysfunction, which will cause arterial stiffness [4].

The two follow-up points in the study of Dwivedi et al. [1] are post-operative 30 days and a long-term follow-up point. The diameter of CFA in long-term scan is higher than in post-operative scan at 30 days. Intimal hyperplasia may be the main cause of this result.