title: Percutaneous endovascular abdominal aortic aneurysm repair leads to a reduction in wound complications.
abstract: BACKGROUND
  While endovascular aortic aneurysm repair (EVAR) has significantly reduced the morbidity associated with open surgery, efforts continue to minimise the surgical insult to the patient. We report our experience of percutaneous EVAR.
  
  
  METHODS
  Since June 2005, 17/20 EVARs (85%) have been attempted percutaneously by deployment of two Perclose) devices into each femoral artery prior to passage of the device sheath. The sutures are left untied until the sheath is removed at the end of the procedure, when haemostasis is obtained. Patients were entered onto a prospectively maintained database and followed up at regular intervals in a dedicated EVAR clinic.
  
  
  RESULTS
  Access and subsequent graft deployment was successful in all the 17 cases. The range of defects closed ranged from 12-24 Fr. Five patients (29%) required open groin exploration at the end of the procedure to achieve haemostasis. There was a significantly lower incidence of wound complications in the percutaneous EVAR group (6 vs. 10% open cutdown cases, P < 0.05, Mann-Whitney U test).
  
  
  CONCLUSIONS
  Percutaneous EVAR is both a feasible and safe method of performing endovascular abdominal aortic aneurysm repair, which is associated with a reduction in wound complication rates.
authors.affiliation: St. James's Vascular Institute, St. James's Hospital, Dublin 8, Ireland. ciaranomcdonnell@gmail.com
authors.forename: C O
authors.initials: CO
authors.lastname: McDonnell
authors.forename: M V
authors.initials: MV
authors.lastname: Forlee
authors.forename: J F
authors.initials: JF
authors.lastname: Dowdall
authors.forename: M-P
authors.initials: MP
authors.lastname: Colgan
authors.forename: P
authors.initials: P
authors.lastname: Madhavan
authors.forename: G D
authors.initials: GD
authors.lastname: Shanik
authors.forename: D J
authors.initials: DJ
authors.lastname: Moore
mesh_terms: D017130:Angioplasty / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D006488:Hemostasis, Surgical; D006801:Humans; D011183:Postoperative Complications / Q000517:prevention & control; D011446:Prospective Studies; D016896:Treatment Outcome