title: Percutaneous endovascular treatment of aortic aneurysms: clinical evaluation and literature results.
abstract: In this study we aimed to evaluate the efficiency of percutaneous endovascular aortic aneurysm repair (p-EVAR). Anatomically selected patients treated with a single 10Fr Perclose Prostar XL vascular closure device (VCD) were examined. Primary success rate and common femoral artery (CFA) open conversion (OC) requirement per sheath size used were recorded. A literature review on p-EVAR results was also performed. One-hundred patients were enrolled. Successful p-EVAR was achieved in 183 of the 196 CFA access sites (93.4%), and was specifically 85.9% and 98.3% for sheaths ≥20Fr and ≤18Fr respectively. There were 13 periprocedural complications (bleeding = 10, arterial dissection and thrombosis = 1, pseudoaneurysm = 2) all leading to OC. Use of ≥20Fr sheaths had significantly higher OC rate (P < .05). Reconstruction was achieved with primary repair (N = 11) and patch angioplasty (N = 2). Mean hospital stay was 1.8 days. The literature review (vascular closure of 2921 CFA access sites) revealed an overall technical success rate of 92.3%. Device related- were more common than patient related-OCs (P < .05). p-EVAR procedures are safe and feasible. Sheath size is a significant predictor of OC rate and more OCs might be expected with very large (≥20Fr) sheath sizes.
authors: Vascular Surgery Department, "Hellenic Air Force" Hospital, Athens, Greece.
authors: Theodossios P
authors: TP
authors: Perdikides
authors: George S
authors: GS
authors: Georgiadis
authors: Efthimios D
authors: ED
authors: Avgerinos
authors: Kosmas I
authors: KI
authors: Paraskevas
authors: Konstantinos X
authors: KX
authors: Siafakas
authors: Athanasios
authors: A
authors: Katsargyris
authors: Theofanis
authors: T
authors: Fotis
authors: Konstantinos G
authors: KG
authors: Lagios
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D000800:Angioplasty, Balloon; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D019917:Blood Vessel Prosthesis Implantation; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D005263:Femoral Artery; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D014463:Ultrasonography