Canadian experience with percutaneous endovascular aneurysm repair: short-term outcomes.
BACKGROUND
To decrease the morbidity associated with cut-downs during endovascular aneurysm repair, some authors have suggested the totally percutaneous endovascular repair (PEVAR). The goal of this report is to evaluate and describe our centre's experience with the total percutaneous endovascular aneurysm repair (PEVAR) for aortic abdominal aneurysm (AAA).


METHODS
We performed a retrospective analysis of 15 consecutive patients with AAA, including 1 with right common iliac artery aneurysm.


RESULTS
There were 12 men and 3 women with a mean age of 74 (standard deviation [SD] 2) years who underwent PEVAR with a Perclose ProGlide suture-mediated closure system between July 2007 and July 2008. All surgeries were elective. Forty percent of patients had a history of smoking, 73% were hypertensive, 33% were diabetic, 20% had chronic obstructive pulmonary disease and 40% had coronary artery disease. Fourteen patients had bilateral deployment for bifurcated devices (7 bifurcated Gore Excluder, 7 bifurcated Cook Zenith grafts), and 1 patient had unilateral deployment for a Cook Zenith device. The outer diameter of the sheaths used for puncture sites was on average 18.1-Fr (SD 0.6), with main bodies being 21.1-Fr (SD 0.3) and contralateral sides 15-Fr (SD 0.3). Procedural success was 93%, with 1 patient requiring a femoral artery cut-down because of failure of the Perclose device to deploy in the groin. Another patient had persistent venous bleeding in 1 puncture site that stopped with skin suturing. Endovascular aneurysm repair was 100% with no conversion to open surgery and no type-I endoleaks. The mean length of stay in hospital was 2.2 (SD 0.4) days. There were no long-term groin complications at 6 (SD 1) months' follow-up.


CONCLUSIONS
To our knowledge, this is the first Canadian report of experience with PEVAR using the Perclose device. The technique is safe, reliable and allows discharge of patients soon after surgery.
Division of Vascular Surgery, Vancouver General Hospital, University of British Columbia, Vancouver, BC.
S Marlene
SM
Grenon
Joel
J
Gagnon
York N
YN
Hsiang
Jerry C
JC
Chen
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000379:methods; D017130:Angioplasty / Q000379:methods*; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000379:methods*; D001955:British Columbia; D015331:Cohort Studies; D017558:Elective Surgical Procedures; D005260:Female; D005500:Follow-Up Studies; D006784:Hospitals, Teaching; D006785:Hospitals, University; D006801:Humans; D007083:Iliac Artery / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D011475:Prosthesis Failure; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000379:methods