TY - JOUR
T1 - Percutaneous closure of femoral artery access sites in endovascular stent-graft treatment of aortic disease
AU - Shim, Chi Young
AU - Park, Sungha
AU - Ko, Young Guk
AU - Choi, Donghoon
AU - Jang, Yangsoo
AU - Shim, Won Heum
PY - 2008/11/12
Y1 - 2008/11/12
N2 - Background: Endovascular techniques using various stent-graft systems are now available to treat aortic disease. Because stent-grafts need large-bore sheaths, arterial surgical cut-downs for access and closure are required. This study describes and reports the results of a percutaneous technique using multiple Perclose devices (Closer-S, 6 Fr) for large arteriotomy closure. Methods: Sixty-six patients (50 males; mean age 62.8 ± 11.8 years) with endovascular stent-graft treatment (from Feb. 2004 to Jan. 2006) were studied. A total of 92 femoral sites were required for large-bore (larger than 14 Fr) sheaths insertion. Stent-graft devices were introduced through 20 Fr (n = 8), 18 Fr (n = 29), 16 Fr (n = 29) or 14 Fr (n = 26) sheaths. After deployment of 2 or 3 Percloses (Closer-S, 6 Fr), arteriotomies were dilated to create an appropriate size for large-bore sheaths insertion. After stent-graft insertion, hemostasis was achieved using multiple Perclose sutures placed prior to arterial dilatation. All femoral sites were followed with physical examination and CT angiography. Results: Percutaneous closures with 2 or 3 Perclose devices were successful in 95.7% (88/92) of femoral sites, without complication of hematoma, infection, pseudoaneurysm, or arterial thromboses. In 4.3% (4/92), arterial complications requiring vascular surgical repair occurred. Conclusion: Percutaneous closure technique using 2 or 3 Perclose devices placed prior to arterial dilatation is useful for hemostasis in endovascular stent-graft treatment of aortic disease.
AB - Background: Endovascular techniques using various stent-graft systems are now available to treat aortic disease. Because stent-grafts need large-bore sheaths, arterial surgical cut-downs for access and closure are required. This study describes and reports the results of a percutaneous technique using multiple Perclose devices (Closer-S, 6 Fr) for large arteriotomy closure. Methods: Sixty-six patients (50 males; mean age 62.8 ± 11.8 years) with endovascular stent-graft treatment (from Feb. 2004 to Jan. 2006) were studied. A total of 92 femoral sites were required for large-bore (larger than 14 Fr) sheaths insertion. Stent-graft devices were introduced through 20 Fr (n = 8), 18 Fr (n = 29), 16 Fr (n = 29) or 14 Fr (n = 26) sheaths. After deployment of 2 or 3 Percloses (Closer-S, 6 Fr), arteriotomies were dilated to create an appropriate size for large-bore sheaths insertion. After stent-graft insertion, hemostasis was achieved using multiple Perclose sutures placed prior to arterial dilatation. All femoral sites were followed with physical examination and CT angiography. Results: Percutaneous closures with 2 or 3 Perclose devices were successful in 95.7% (88/92) of femoral sites, without complication of hematoma, infection, pseudoaneurysm, or arterial thromboses. In 4.3% (4/92), arterial complications requiring vascular surgical repair occurred. Conclusion: Percutaneous closure technique using 2 or 3 Perclose devices placed prior to arterial dilatation is useful for hemostasis in endovascular stent-graft treatment of aortic disease.
KW - Closure
KW - Percutaneous
KW - Stent-graft
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U2 - 10.1016/j.ijcard.2007.08.086
DO - 10.1016/j.ijcard.2007.08.086
M3 - Article
C2 - 18234376
AN - SCOPUS:54549121542
SN - 0167-5273
VL - 130
SP - 251
EP - 254
JO - International Journal of Cardiology
JF - International Journal of Cardiology
IS - 2
ER -