Journal Article

Predictors and Treatments of Proglide-Related Complications in Percutaneous Endovascular Aortic Repair

Hu, Guohua, Guo, Daqiao, Wang, Yuqi, Jiang, Junhao, Fu, Weiguo, Xu, Xin, Chen, Bin, Yang, Jue

2015

Overview

To investigate the predictors and treatment of the 6-Fr Perclose Proglide-related complications (PRC) in percutaneous endovascular aortic repair (pEVAR). We retrospectively analyzed the PRC after pEVAR for the treatment of aortic aneurysm or dissection in our center from December 2012 to November 2013. Procedure success was defined as effective functioning of the two devices and local hemostasis. Access-related adverse events included vascular complications and device failures. Operative data and angiographic and computed tomography images were collected to assess the complications and treatment strategy. A total of 198 patients with 275 puncture sites underwent pEVAR with the 6-Fr Perclose Proglide. The procedure was successful in 178 patients (89.9%), whereas PRC occurred in 20 cases (10.1%), including 10 device failures and 10 vascular complications. An extra manual ancillary compression was conducted in 7 patients, one more device was used in 8 patients, and surgical repair of the femoral artery was performed in 5 patients. PRC had a tendency to occur in patients with body mass index (BMI)>30 kg/m2 (p = 0.021), thoracic stent grafts (p = 0.038), common femoral artery (CFA) calcification (p = 0.001), CFA depth>4 cm (p = 0.001), and sheath size>20Fr (p = 0.005). Device failure-related mortality was zero. None of the access sites had complications during the midterm follow-up. The pre-close technique with 6-Fr Perclose Proglide devices for pEVAR appears to be safe and effective with low technical failure and complication rates. Careful patient selection and proficiency in device manipulation might reduce the device related complications.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Abdomen / Aneurysm / Aneurysms / Aorta / Aorta - surgery / Body mass / Body mass index / Body size / Calcification / Cardiovascular system / Care and treatment / Complications / Complications and side effects / Compression / Computed tomography / Demographics / Endovascular Procedures - adverse effects / Endovascular Procedures - instrumentation / Failure / Female / Femoral artery / Femur / Follow-Up Studies / Grafts / Hemostasis / Hemostatics / Hospitals / Humans / Implants / Ischemia / Male / Medical imaging / Middle Aged / Multivariate analysis / Patients / Postoperative Complications - etiology / Postoperative Complications - therapy / Punctures / Retrospective Studies / Studies / Success / Surgery / Surgical implants / Thorax / Vascular surgery / Veins & arteries