Percutaneous endovascular treatment of aortic aneurysms: clinical evaluation and literature results

Theodosios Perdikides, George S. Georgiadis, Efthimios Avgerinos, Kosmas I. Paraskevas, Konstantinos X. Siafakas, Athanasios Katsargyris, Theofanis Fotis, Konstantinos G. Lagios

Research output: Contribution to journalArticlepeer-review

Abstract

In this study we aimed to evaluate the efficiency of percutaneous endovascular aortic aneurysm repair (p-EVAR). Anatomically selected patients treated with a single 10Fr Perclose Prostar XL vascular closure device (VCD) were examined. Primary success rate and common femoral artery (CFA) open conversion (OC) requirement per sheath size used were recorded. A literature review on p-EVAR results was also performed. One-hundred patients were enrolled. Successful p-EVAR was achieved in 183 of the 196 CFA access sites (93.4%), and was specifically 85.9% and 98.3% for sheaths ≥20Fr and ≤18Fr respectively. There were 13 periprocedural complications (bleeding = 10, arterial dissection and thrombosis = 1, pseudoaneurysm = 2) all leading to OC. Use of ≥20Fr sheaths had significantly higher OC rate (P < .05). Reconstruction was achieved with primary repair (N = 11) and patch angioplasty (N = 2). Mean hospital stay was 1.8 days. The literature review (vascular closure of 2921 CFA access sites) revealed an overall technical success rate of 92.3%. Device related- were more common than patient related-OCs (P < .05). p-EVAR procedures are safe and feasible. Sheath size is a significant predictor of OC rate and more OCs might be expected with very large (≥20Fr) sheath sizes.
Original languageEnglish
Pages (from-to)342-350
Number of pages9
JournalMinimally Invasive Therapy and Allied Technologies
Volume21
Issue number5
DOIs
Publication statusPublished - 30 Sept 2012

Keywords

  • Percutaneous
  • EVAR
  • aortic aneurysm
  • vascular closure devices
  • pre-close technique

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