Percutaneous Endovascular Abdominal Aortic Aneurysm Repair

Percutaneous closure of femoral artery access sites in endovascular stent-graft treatment of aortic disease

“…The results of this study suggest that pre-closure technique with multiple 6 Fr Perclose devices is safe to achieve hemostasis when using larger sheaths, without any local complication. The overall failure rate in our study was lower than that described in previous studies using Prostar XL [7,8,10,17]. Very few patients experienced complications requiring surgical repairs.…”

“…Very few patients experienced complications requiring surgical repairs. Factors which may have affected successful closure have been considered as larger sheath size, patient gender, obesity, diabetes, previous femoral access and iliofemoral occlusive disease [17]. But, there were no patients with severe obesity and severely scarred groin from previous femoral access in present study.…”

“…Vascular complications are rare [14]. In previous studies, investigators introduced the so called "Pre-closure" technique for large-bore arteriotomies using percutaneous closure devices [7][8][9][10][15][16][17]. This technique originated from the modified percutaneous approach in 1997, which included a short incision and 3-0 suture through the fascia for safe sheath removal [15].…”

“…Because endovascular techniques for aortic diseases require large-bore vascular access, suture-mediated percutaneous closure has been International Journal of Cardiology 130 (2008) 251 -254 www.elsevier.com/locate/ijcard described using the "Pre-close technique" [7][8][9][10][15][16][17]. In previous studies [7,8,10,17], the Prostar XL percutaneous vascular device (Perclose, Menlo Park, CA) was used, but there is no study using the more popular and practiced suturemediated closure device, Closer-S. This is an observational study to investigate the efficacy and safety of the pre-close technique using multiple Perclose devices (Closer-S, 6 Fr, Abbott Vascular Devices, CA, USA) to close arterial puncture sites following the deployment of stent-graft devices.…”

Percutaneous endovascular abdominal aortic aneurysm repair leads to a reduction in wound complications

“…Our findings of a decreased wound complication rate with percutaneous EVAR is similar to that of Rachel et al [6] who reported a 0.9% complication rate in percutaneous closures versus 3.6% of those who underwent open cutdowns. Interestingly, these authors, unlike others, did not find that factors such as previous femoral access, obesity and iliac occlusive disease were predictive of failure.…”