Percutaneous Suture-mediated Closure Versus Surgical Arteriotomy in Endovascular Aortic Aneurysm Repair

Etezadi, Vahid; Katzen, Barry T.; Naiem, Amer; Johar, A.S.; Wong, Scott; Fuller, Joseph C.; Benenati, James F.

doi:10.1016/j.jvir.2010.10.008

Cited by 39 publications

(74 citation statements)

References 11 publications

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“…This approach can shorten the time to ambulation and discharge [1,2,10,13,14]. The complication rate of the percutaneous approach is comparable to that of surgical cut down.…”

Section: Discussionmentioning

confidence: 95%

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Retrospective Evaluation of Percutaneous Access for TEVAR and EVAR: Time to Make it the Standard Approach?

Thomas

Kowald

Schmuck

et al. 2017

Fortschr Röntgenstr

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Introduction?To evaluate the safety of percutaneous endovascular aortic repair and the relationship of access site characteristics to complications Materials and Methods?All patients undergoing percutaneous TEVAR, EVAR and FEVAR procedures from January 2010 to May 2016 were retrospectively analysed for incidence of complications and their relationship to various access site characteristics like access artery size, degree of vessel calcification, skin to artery distance and sheath to artery ratio. Hemostasis occurring within 15?min after suture closure with or without manual compression was defined as primary hemostasis. Results?92 patients with 142 femoral access sites were included in the study. Median follow-up was 28.13 months (range 2.5???76.7 months, Mean 32.39, SD ? 21.66 months). Introducer system size ranged from 12F to 25F. Primary haemostasis was achieved in 97.1?% (138/142) of the total femoral access sites. Four access sites (2.8?%) had to be closed surgically; in all 4 cases the introducer systems was ??18F. Two of these access sites had been operated upon previously. Late complications including inguinal hematoma (n?=?7), wound infection (n?=?1), scrotal hematoma (n?=?1), pseudoaneurysm (n?=?4) and late bleeding (n?=?4) occurred in 17 access sites (11.9?%), of which 13 were managed conservatively. On account of the low complication rate, no correlation between the evaluated variables and observed complications could be established. Conclusion?Percutaneous endovascular aortic repair is feasible and safe irrespective of the size of the introducer sheath and the nature of aorto-iliac pathology. The technical success rate is high and the incidence of complications is low. Early complications are most often associated with sheath sizes ??18 F. The majority of the late complications can be treated conservatively. Key points:? Citation Format

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“…This approach can shorten the time to ambulation and discharge [1,2,10,13,14]. The complication rate of the percutaneous approach is comparable to that of surgical cut down.…”

Section: Discussionmentioning

confidence: 95%

“…Even today many centers still resort to femoral arteriotomy for endograft implantation. However, femoral arterial exposure is associated with possible complications like hematoma, seroma, lymphoceles, infection and scar formation [2].…”

Section: Introductionmentioning

confidence: 99%

Retrospective Evaluation of Percutaneous Access for TEVAR and EVAR: Time to Make it the Standard Approach?

Thomas

Kowald

Schmuck

et al. 2017

Fortschr Röntgenstr

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“…Initially, surgical arteriotomy was required for femoral artery access and closure; however, this technique has several disadvantages, including the necessity for general or spinal anesthesia, prolonged procedure duration, and increased post-procedure morbidity (4). More recently, a true percutaneous approach to transfemoral-TAVI using the Prostar XL vascular closure system (Abbott Vascular, Santa Clara, California) has been performed.…”

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confidence: 99%

True Percutaneous Approach for Transfemoral Aortic Valve Implantation Using the Prostar XL Device

Hayashida

Lefèvre

Chevalier

et al. 2012

JACC: Cardiovascular Interventions

108

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“…Several recent articles have described the noninferiority of this percutaneous approach over the classic femoral cutdown for endovascular aortic repair [1][2][3][4]. In addition, patients who underwent percutaneous access had shorter hospital stay, reduced procedure-related complications and overall improved patient satisfaction compared with open femoral access.…”

Section: Introductionmentioning

confidence: 99%

“…However, the size of the arteriotomy can be seen as the major limiting factor for the percutaneous approach [4,9]. The size of the arteriotomy is determined by the outer diameter (OD) of the vascular sheath or the sheathless delivery device.…”

Section: Introductionmentioning

confidence: 99%

Local Anesthesia for Percutaneous Thoracic Endovascular Aortic Repair

Dorp¹,

Gilbers²,

Lauwers³

et al. 2016

aorta

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Background: Thoracic endovascular aortic repair (TEVAR) requires large-bore vascular access due to the considerable diameters of the endoprosthesis and delivery device. The preclose technique preceding endograft delivery has opened the door for an evolved access strategy. In addition, treatment under local anesthesia offers the advantage of optimal neuromonitoring. The goal of this study was to analyze the efficacy and safety of percutaneous TEVAR under local anesthesia. Methods: All patients undergoing TEVAR in an elective setting at the Antwerp University Hospital between June 2012 and June 2015 were prospectively entered into an endovascular database. This database was queried for demographics, procedural details, and access-related complications. All patients underwent a percutaneous approach with the Perclose Proglide under local anesthesia. Results: This review identified 34 patients in whom 37 percutaneous TEVAR procedures were completed under local anesthesia. All patients experienced adequate analgesia, and no conversions to general anesthesia were implemented. The mean size of the arteriotomy was 23.8 ± 1.3 French (F). The number of Proglide deployments was 80, with an 8% rate of failure on deployment. There were no conversions to surgical cutdown, and adequate hemostasis was obtained in all procedures. The incidence of postprocedural access-related complications was 3%. Conclusion: Local anesthesia for percutaneous TEVAR can be performed safely and effectively. The percutaneous approach facilitates local anesthesia, which provides the added benefit of early recognition of neurologic complications while maintaining a low risk

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Percutaneous Suture-mediated Closure Versus Surgical Arteriotomy in Endovascular Aortic Aneurysm Repair

Cited by 39 publications

References 11 publications

Retrospective Evaluation of Percutaneous Access for TEVAR and EVAR: Time to Make it the Standard Approach?

Retrospective Evaluation of Percutaneous Access for TEVAR and EVAR: Time to Make it the Standard Approach?

True Percutaneous Approach for Transfemoral Aortic Valve Implantation Using the Prostar XL Device

Local Anesthesia for Percutaneous Thoracic Endovascular Aortic Repair

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