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. 2018 Oct 30:41:8-9.
doi: 10.1016/j.ejvssr.2018.10.001. eCollection 2018.

An Alternative Technique to Achieve Haemostasis During PEVAR Using Perclose ProGlide

Giuseppe Baldino  1 , Federica Persi  1 , Paolo Mortola  1 , Amerigo Gori  1
Affiliations

An Alternative Technique to Achieve Haemostasis During PEVAR Using Perclose ProGlide

Giuseppe Baldino et al. EJVES Short Rep. .

Abstract

Introduction: Percutaneous endovascular abdominal aortic aneurysm repair (PEVAR) using the Perclose ProGlide suture mediated closure device is currently performed on a global scale. A safe, effective, and cheap technique for achieving haemostasis during PEVAR is described that allows the reversible downsizing of the arteriotomy, without using any other devices.

Technique: The procedure consists of pulling the blue thread of the pre-implanted ProGlide, advancing the knot close to the arterial wall by pushing it with the dilator of a small introducer sheath, and maintaining the system under tension by grasping the end of the blue thread with a haemostat until bleeding control is achieved.

Discussion: Seventeen PEVAR femoral access downsizing procedures have been performed between February and June 2018 and no complications were observed. The technique could be useful in everyday practice and has now become the author's standard practice.

Keywords: Femoral artery access downsizing; PEVAR.

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Figures

Figure 1
Figure 1
Model of the described technique. (A) The loose knot (arrow) and the insertion of the 6F introducer sheath dilator. (B) The tightened knot (arrow) is fixed with the dilator by grasping the blue rail suture of the ProGlide.
Figure 2
Figure 2
In vivo demonstration of the downsizing technique (from 20F to 11F) with both blue rail sutures kept under tension by the haemostats.
See this image and copyright information in PMC

References

    1. Nelson P.R., Krajcer Z., Kansal N., Rao V., Bianchi C., Hashemi H. A multicenter, randomized, controlled trial of totally percutaneous access versus open femoral exposure for endovascular aortic aneurysm repair (the PEVAR trial) J Vasc Surg. 2014;59:1181–1194. - PubMed
    1. Buck D.B., Karthaus E.G., Soden P.A., Ultee K.H., van Herwaarden J.A., Moll F.L. Percutaneous versus femoral cutdown access for endovascular aneurysm repair. J Vasc Surg. 2015;62:16–21. - PMC - PubMed
    1. Schwartz B.G., Burstein S., Economides C., Kloner R.A., Shavelle D.M., Mayeda G.S. Review of vascular closure devices. J Invasive Cardiol. 2010;22:599–607. - PubMed
    1. Krajcer Z., Ramaiah V.G., Henao E.A., Metzger D.C., Nelson W.K., Moursi M.M. LIFE registry investigators. perioperative outcomes from the prospective multicenter least invasive fast-track EVAR (LIFE) registry. J Endovasc Ther. 2018;25:6–13. - PubMed
    1. Pratesi G., Barbante M., Pulli R., Fargion A., Dorigo W., Bisceglie R., IPER Registry Collaborators Italian Percutaneous EVAR (IPER) Registry: outcomes of 2381 percutaneous femoral access sites' closure for aortic stent-graft. J Cardiovasc Surg. 2015;56:889–898. - PubMed

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