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. 2024 Sep 10;7(1):66.
doi: 10.1186/s42155-024-00476-0.

Investigating the effects of percutaneous endovascular aneurysm repair for abdominal aortic aneurysm on the lumen size of the common femoral artery

Wilson Wei Xiang Ong  1 , Hsien Ts'ung Tay  2 , Tze Tec Chong  2
Affiliations

Investigating the effects of percutaneous endovascular aneurysm repair for abdominal aortic aneurysm on the lumen size of the common femoral artery

Wilson Wei Xiang Ong et al. CVIR Endovasc. .

Abstract

Background: Percutaneous endovascular aneurysm repair (PEVAR) is the definitive therapy of choice for abdominal aortic aneurysms worldwide. However, current literature regarding the anatomic changes in the common femoral artery (CFA) post-PEVAR is sparse and contradictory, and a significant proportion of these studies did not control for the potential confounding effects of ethnicity. Thus, this study aims to investigate the anatomical effects of PEVAR on the CFA using an Asian study cohort.

Methods: Between January 2019 and September 2023, the records of 113 patients who received PEVAR were reviewed. Groins with previous surgical interventions were excluded. The most proximate pre- and postoperative CT angiography of patients receiving PEVAR via the Perclose ProGlide™ Suture-Mediated Closure System were retrospectively analysed for changes in both the CFA inner luminal diameter (ID) and outer diameter (OD), the latter also encompassing the arterial walls. Access site complications within 3 months post-PEVAR were also recorded per patient.

Results: One hundred seventeen groins from 60 patients were included in this study, with 1 report of pseudoaneurysm. The CFA ID exhibited a 0.167 mm decrease (p-value = 0.0403), while the OD decreased by 0.247 mm (p-value = 0.0107). This trend persisted when the data was separately analysed with the common cardiovascular risk factors of diabetes mellitus, hypertension and hyperlipidaemia.

Conclusion: Our analysis demonstrated a statistically significant decrease in the CFA diameters post-PEVAR. However, the percentage changes were below established flow-limiting values, as reflected by the single access site complication reported. Hence, our findings give confidence in the safety profile of this procedure, even with the reported smaller baseline CFA lumen size in Asians. Moving forward, similar longer-term studies should be considered to characterise any late postoperative effects.

Keywords: Abdominal aortic aneurysm; Common femoral artery; Inner diameter; Outer diameter; Percutaneous endovascular aneurysm repair; Surgical outcomes.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Postoperative computed tomography series of a left common femoral artery illustrating the anatomical locations at which the diameters of the common femoral artery were recorded. A, B Respective axial and coronal images of the common femoral artery at the proximal origin below the inguinal ligament. C, D Respective axial and coronal images at the midpoint of the common femoral artery. E, F Respective axial and coronal images of the distal common femoral artery just proximal to the profunda bifurcation
Fig. 2
Fig. 2
Flowchart illustrating the study cohort selection process
See this image and copyright information in PMC

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