Safety and Effectiveness of a Sequential Suture and Plug Vascular Closure Devices Technique for Large-Bore Access Closure after Percutaneous Endovascular Aneurysm Repair |
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Institution: | 1. Department of Vascular Surgery, Rouen University Hospital, Rouen, France;2. Department of Digestive Surgery, Rouen University Hospital, Rouen, France;1. Department of Diagnostic Radiology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore;2. Department of General Surgery, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore;1. Department of Radiology, City of Hope Medical Center, Duarte, California;2. Department of Diagnostic Imaging, The Warren Alpert Medical School, Brown University, Providence, Rhode Island;1. Department of Radiology and Biomedical Imaging, Stanford University, San Francisco, California;2. Department of General Hepatology and Liver Transplantation, University of California, Stanford University, San Francisco, California;3. Department of Gastroenterology & Hepatology, Stanford University, San Francisco, California |
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Abstract: | PurposeTo evaluate the safety and effectiveness of sequential sutures and plugged vascular closure devices (VCDs) for large-bore access closure during percutaneous access endovascular aneurysm repair (PEVAR).Materials and MethodsData on 16 patients who underwent PEVAR at the authors’ center from January 2022 to May 2022 were retrospectively reviewed. The median age was 72 years (interquartile range IQR], 59–75 years), with a male-to-female ratio of 3:1. All patients received sequential suture and plug VCDs using dual Exoseal after 1 Proglide for access closure. Success was defined as the ability to achieve complete hemostasis and was confirmed by ultrasonography. The patients were followed up for access-related adverse events at 30 and 90 days after the procedure, and the severity was graded according to the Society of Interventional Radiology (SIR) classification.ResultsOverall, 24 access sites were included. The median sheath size was 21 F (IQR, 18–23 F). The median hemostasis time was 11.0 minutes (IQR, 9.3–13.0 minutes), the median procedural time was 133.5 minutes (IQR, 102.5–151.0 minutes), and the median length of stay was 5 days (IQR, 4.0–6.8 days). The success rate was 95.8%, and a pseudoaneurysm (SIR Grade 2) developed in 1 patient, which was treated by a percutaneous injection of thrombin. No other access-related adverse events occurred, and the total adverse event rate was 4.2%.ConclusionsPlacement of sequential suture and plug VCDs using 1 Proglide and dual Exoseal is a safe and effective method and may be an option for access closure during PEVAR. |
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