Ultrasound-guided puncture of the femoral artery for total percutaneous aortic aneurysm repair

Oğuzkurt, Levent; Gürel, Kamil; Eker, H. Evren; Gür, Serkan; Özkan, Uğur; Gülcan, Öner

doi:10.4261/1305-3825.dir.4061-10.1

Cited by 12 publications

(15 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Starnes et al 7 demonstrated, in a study of 59 and 93 arteries accessed with and without US respectively, that US guidance significantly decreased their conversion to open repair in sheaths > 20 Fr (0% vs. 14%, P < .05) as well as significantly increased their technical success rate in sheaths > 20 Fr (100% vs. 82%, P < .05). In a study of 52 patients and 85 arteries by Oquzkurt et al 8 , technical success was achieved in 49 patients (94%) and there were no wound complications at the end of the case and at their 30 day follow-up visit.…”

Section: Discussionmentioning

confidence: 90%

See 1 more Smart Citation

Ultrasound-guided percutaneous endovascular aneurysm repair success is predicted by access vessel diameter

Bensley

Hurks

Huang

et al. 2012

Journal of Vascular Surgery

View full text Add to dashboard Cite

Introduction Ultrasound guided access allows for direct visualization of the access artery during percutaneous endovascular aortic aneurysm repair. We hypothesize that the use of ultrasound guidance allowed us to safely increase the utilization of percutaneous endovascular aortic aneurysm repair to almost all patients and decrease access complications. Methods A retrospective chart review of all elective endovascular aortic aneurysm repairs, both abdominal and descending thoracic, from 2005-2010 was performed. Patients were identified using ICD9 codes and stratified based on access type: percutaneous vs. cutdown. We examined the success rate of percutaneous access and the cause of failure. Sheath size was large (18-24 Fr) or small (12-16 Fr). Minimum access vessel diameter was also measured. Outcomes were wound complications (infections or clinically significant hematomas that delayed discharge or required transfusion), operative and incision time, length of stay, and discharge disposition. Predictors of percutaneous failure were identified. Results 168 patients (296 arteries) had percutaneous access (P-EVAR) while 131 patients (226 arteries) had femoral cutdown access (C-EVAR). Ultrasound guided access was introduced in 2007. P-EVAR increased from zero cases in 2005 to 92.3% of all elective cases in 2010. The success rate with percutaneous access was 96%. Failures requiring open surgical repair of the artery included 7 for hemorrhage and 6 for flow limiting stenosis or occlusion of the femoral artery. P-EVAR had fewer wound complications (0.7% vs. 7.4%, P = .001) shorter operative time (153.3 vs. 201.5 minutes, P < .001) and larger minimal access vessel diameter (6.7 mm vs. 6.1 mm, P < .01). Patients with failed percutaneous access had smaller minimal access vessel diameters when compared to successful P-EVAR (4.9 mm vs. 6.8 mm, P < .001). More failures occurred in small sheaths than large ones (7.4% vs. 1.9%, P = .02). Access vessel diameter < 5 mm is predictive of percutaneous failure (16.7% of vessels < 5 mm failed vs. 2.4% of vessels ≥ 5 mm, P < .001) (OR 7.3, 95% CI [1.58-33.8], P = .01). Conclusion Ultrasound guided percutaneous EVAR can be performed in the vast majority of patients with a high success rate, shorter operative times, and fewer wound complications. Access vessel diameters less than 5 mm are at greater risk for percutaneous failure and should be treated selectively.

show abstract

Section: Discussionmentioning

confidence: 90%

“…Among prior reports including 50 or more patients, the technical success rates of percutaneous access have ranged between 76% and 96% 3-7 . The utilization of ultrasound guidance has been suggested to improve accuracy and lower the complication rate associated with percutaneous access 7, 8 .…”

Section: Introductionmentioning

confidence: 99%

Ultrasound-guided percutaneous endovascular aneurysm repair success is predicted by access vessel diameter

Bensley

Hurks

Huang

et al. 2012

Journal of Vascular Surgery

View full text Add to dashboard Cite

show abstract

“…21 Our technical success rate of 95% compares favorably with prior reports (Table III). [1][2][3][4][5][6][7][8][9][10][11][12]14,20,[22][23][24][25][26][27][28][29][30][31][32][33][34][35][36] Despite the use of different devices and some variations on techniques, three meta-analysis have shown >90% technical success with a low incidence of complications. 13,37,38 With respect to reports dealing with thoracic or fenestrated and branched endografts, there are limited data.…”

Section: Discussionmentioning

confidence: 97%

Outcomes of total percutaneous endovascular aortic repair for thoracic, fenestrated, and branched endografts

Souza

Oderich

Banga

et al. 2015

Journal of Vascular Surgery

View full text Add to dashboard Cite

show abstract

“…It may shorten the duration of the preprocedural preparation of the CFAs. The reported technical success rates are high (26). The surgeon must be comfortable with obtaining percutaneous access and using closure devices in patients who might be hemodynamically unstable.…”

Section: Discussionmentioning

confidence: 99%

Endovascular repair of thoracic and abdominal aortic ruptures: a single-center experience

İslim

Salık²,

Güven³

et al. 2014

Diagn Interv Radiol

View full text Add to dashboard Cite

consecutive patients (nine males, two females; age range, 26-80 years) with thoracic and abdominal aortic ruptures underwent endovascular repair in our unit. Thoracoabdominal computed tomography (CT) angiography was performed for diagnosis and follow-up. Patients were selected for endovascular repair by a cardiovascular surgeon, anesthesiologist, and interventional radiologist. All repairs were performed using commercially available stent-grafts. The patients were followed up with CT angiography before discharge, at six months, and yearly thereafter. RESULTSThree patients died by day 30. One patient died due to an unsuccessful procedure and hemodynamic instability; two patients died because of comorbidities. The other eight patients were followed for six to 24 months after the procedure. No endoleaks or late ruptures were observed during the follow-up period. The patient with iatrogenic thoracic aortic rupture developed paraplegia after the procedure. CONCLUSIONReduced mortality due to aortic rupture has been reported with the expanding use of endovascular repair. Reports of small centers are important because of the rarity of these pathologies, and because transferring patients with aortic rupture to a referral center is not usually possible.

show abstract

Ultrasound-guided puncture of the femoral artery for total percutaneous aortic aneurysm repair

Cited by 12 publications

References 18 publications

Ultrasound-guided percutaneous endovascular aneurysm repair success is predicted by access vessel diameter

Ultrasound-guided percutaneous endovascular aneurysm repair success is predicted by access vessel diameter

Outcomes of total percutaneous endovascular aortic repair for thoracic, fenestrated, and branched endografts

Endovascular repair of thoracic and abdominal aortic ruptures: a single-center experience

Contact Info

Product

Resources

About