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

Minim Invasive Ther Allied Technol. 2012 Sep;21(5):342-50. doi: 10.3109/13645706.2011.638642. Epub 2011 Nov 29.

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.

Publication types

  • Evaluation Study
  • Review

MeSH terms

  • Aged
  • Aged, 80 and over
  • Angioplasty, Balloon
  • Aortic Aneurysm, Abdominal / diagnostic imaging
  • Aortic Aneurysm, Abdominal / surgery
  • Aortic Aneurysm, Abdominal / therapy*
  • Aortic Dissection / diagnostic imaging
  • Aortic Dissection / surgery
  • Aortic Dissection / therapy*
  • Blood Vessel Prosthesis Implantation
  • Endovascular Procedures / methods*
  • Female
  • Femoral Artery
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Sensitivity and Specificity
  • Ultrasonography