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. 2023 Jan 25:88:e47-e52.
doi: 10.5114/pjr.2023.124682. eCollection 2023.

Suture-mediated closure devices for percutaneous endovascular abdominal aneurysm repair

Tomasz Szpotan  1   2 , Maciej Czernik  1 , Agata Majos  2
Affiliations

Suture-mediated closure devices for percutaneous endovascular abdominal aneurysm repair

Tomasz Szpotan et al. Pol J Radiol. .

Abstract

Purpose: Endovascular procedures such as endovascular aneurysm repair or transcatheter aortic valve implantation have become very common because of reduced patient traumatisation and the ability to use shorter or local anaesthesia. In these procedures large-bore sheath devices are used. Access with percutaneous closure is an alternative method to surgical cutdown in groins. The aim of the study was to assess the correlation between sheath size and unsuccessful haemostasis. In addition, the effectiveness of haemostasis after a percutaneous procedure and the number and type of complications were evaluated.

Material and methods: There were 202 patients included in the study. Patients with abdominal aortic aneurysm were qualified to percutaneous aortic stentgraft implantation with Perclose Proglide preclosure technique.

Results: There were 384 access sites performed with 12F to 22F sheaths during aortic stentgraft implantation with Perclose Proglide (Abbott Vascular, Santa Clara, CA, USA) preclosure technique. High effectiveness of haemostasis (98%), low percentage of short- and mid-term complications (2.6%), and infinitesimal number of surgical conversions (n = 5) were stated in the study. There was no correlation between diameter of used introducer sheath and lack of haemostasis observed (Fisher-Freeman-Halton test; p = 0.122). No relationship between diameter of introducer sheath and number of closure devices was observed (c2 = 2.436; df = 5; p = 0.786).

Conclusions: Large-bore device percutaneous procedures with closure devices are effective and safe. High effectiveness of haemostasis (98%) was observed in the study group, with a low percentage of complications (2.6%). There was no correlation between size of the vascular access and the lack of haemostasis found in the study.

Keywords: AAA; EVAR; TAVI; aneurysm; large-bore sheath; percutaneous access.

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Conflict of interest statement

The authors report no conflict of interest.

Figures

Figure 1
Figure 1
Number and percentage of each sheath diameter (ID) used in the study group
Figure 2
Figure 2
Structure of haemostasis achieved in corelation to the number of closure devices used
Figure 3
Figure 3
Number of closure devices used in corelation to sheath diameter (ID)
Figure 4
Figure 4
A) Inserted stentgraft sheaths during the procedure. B) Small postoperative wound
See this image and copyright information in PMC

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