title: The preclose technique in percutaneous endovascular aortic repair: a systematic literature review and meta-analysis.
abstract: OBJECTIVE
  To establish the efficacy and safety of the preclose technique in total percutaneous endovascular aortic repair (PEVAR).
  
  
  METHODS
  A systematic literature search of Medline database was conducted for series on PEVAR published between January 1999 and January 2012.
  
  
  RESULTS
  Thirty-six articles comprising 2,257 patients and 3,606 arterial accesses were included. Anatomical criteria used to exclude patients from undergoing PEVAR were not uniform across all series. The technical success rate was 94 % per arterial access. Failure was unilateral in the majority (93 %) of the 133 failed PEVAR cases. The groin complication rate in PEVAR was 3.6 %; a minority (1.6 %) of these groin complications required open surgery. The groin complication rate in failed PEVAR cases converted to groin cutdown was 6.1 %. A significantly higher technical success rate was achieved when arterial access was performed via ultrasound guidance. Technical failure rate was significantly higher with larger sheath size (≥20F).
  
  
  CONCLUSIONS
  The preclose technique in PEVAR has a high technical success rate and a low groin complication rate. Technical success tends to increase with ultrasound-guided arterial access and decrease with larger access. When failure occurs, it is unilateral in the majority of cases, and conversion to surgical cutdown does not appear to increase the operative risk.
authors.affiliation: Division of Interventional Radiology and Image-Guided Medicine, Department of Radiology, Emory University School of Medicine, 1364 Clifton Road NE, Atlanta, GA 30322, USA. aajaffan@gmail.com
authors.forename: Abdel Aziz A
authors.initials: AA
authors.lastname: Jaffan
authors.forename: Ethan A
authors.initials: EA
authors.lastname: Prince
authors.forename: Christopher O
authors.initials: CO
authors.lastname: Hampson
authors.forename: Timothy P
authors.initials: TP
authors.lastname: Murphy
mesh_terms: D001014:Aortic Aneurysm / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods; D057510:Endovascular Procedures; D006801:Humans; D011183:Postoperative Complications; D012307:Risk Factors