Femoral arterial access management for endovascular aortic aneurysm repair: evolution and outcome.
Endovascular repair of abdominal and thoracic aortic aneurysms (AAAs and TAAs, respectively) has become the standard of care for anatomically appropriate patients. All the devices developed to date for endograft repair of AAAs and TAAs are deployed through relatively large (12F to 24F) sheaths. Traditionally, this access has required arterial exposure with open cut down, but with the development of suture-mediated arterial closure devices and decreasing profile of delivery sheaths of endografts, there is an increasing trend toward percutaneous endovascular repair of aortic aneurysms. This is an effective and safe approach in a select group of patients. Ultrasound guidance ensures that access is obtained proximal to the common femoral artery bifurcation. The procedure should be performed in a sterile operating room environment, and the physicians performing endovascular repair should be experienced in open arterial exposure, should the closure device fail to close the arteriotomy.
Saint Anthony Hospital, Oklahoma City, OK, USA. shoaibshafique@hotmail.com
Shoaib
S
Shafique
Michael P
MP
Murphy
Alan P
AP
Sawchuk
Dolores
D
Cikrit
Michael C
MC
Dalsing
D017544:Aortic Aneurysm, Abdominal / Q000473:pathology / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000473:pathology / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D005263:Femoral Artery / Q000000981:diagnostic imaging; D006801:Humans; D019060:Minimally Invasive Surgical Procedures; D018579:Patient Selection; D011474:Prosthesis Design; D018570:Risk Assessment; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional