title: Diameter change of common femoral arteries after percutaneous endovascular aortic repair with the use of the preclose technique.
abstract: OBJECTIVE
  One of the major concerns regarding the preclose technique is its influence on the diameter of the accessed common femoral artery (CFA). The aim of our study was to evaluate the CFA diameter change after percutaneous endovascular aortic repair (PEVAR) with the use of the preclose technique.
  
  
  METHODS
  From February 2012 to September 2013, 192 patients who underwent PEVAR with the preclose technique were reviewed. The patients were followed postoperatively with computed tomographic angiography 1, 6, and 12 months after PEVAR, and only those with complete computed tomography studies were included. For each access site, the inner diameter (ID) and outer diameter (OD) of the CFA were measured, and the diameters at various time periods were compared. In addition, the patient cohort was divided into four subgroups according to two parameters: the sheath size (12-16F and 18-24F) and the number of closure devices used for the preclose technique (two devices, more than two devices). The differences in diameter change between the subgroups were analyzed. The significance of the diameter change and the influences of the two parameters were analyzed statistically with the use of the paired t-test, one-way analysis of variance, and two-way analysis of variance.
  
  
  RESULTS
  Fifty-eight patients fulfilled the study criteria. No significant influence on the ID of the accessed CFAs was observed at baseline and 1, 6, and 12 months (9.0 ± 1.75 mm, 9.1 ± 1.70 mm, 8.9 ± 1.72 mm, and 9.0 ± 1.68 mm, respectively). By contrast, a significant increase in initial OD occurred 1 month after PEVAR but gradually decreased in size in the following 11 months (13.0 ± 2.37 mm, 16.4 ± 3.44 mm, 14.2 ± 3.06 mm, and 13.5 ± 2.42 mm, respectively). Both the sheath size and the number of closure devices significantly affected the OD change (P < .001 and P = .037, respectively). The effect produced by the number of closure devices extended to 6 months after PEVAR, but the effect of the sheath size ceased before that time.
  
  
  CONCLUSIONS
  This study demonstrates that PEVAR with the use of the preclose technique does not influence the ID of the accessed CFA, whereas the OD changes gradually over 1 year. These results may indicate that future endovascular interventions can be performed with the use of the same access without the risk of vascular narrowing.
authors.affiliation: Chang Gung University, Taoyuan, Taiwan; Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Yang-Yu
authors.initials: YY
authors.lastname: Lin
authors.affiliation: Chang Gung University, Taoyuan, Taiwan; Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Ren-Fu
authors.initials: RF
authors.lastname: Shie
authors.affiliation: Chang Gung University, Taoyuan, Taiwan; Department of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital, Linkou, Kweishan, Taoyuan, Taiwan.
authors.forename: Kuo-Sheng
authors.initials: KS
authors.lastname: Liu
authors.affiliation: Chang Gung University, Taoyuan, Taiwan; Department of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital, Linkou, Kweishan, Taoyuan, Taiwan.
authors.forename: Shang-Yueh
authors.initials: SY
authors.lastname: Yu
authors.affiliation: Chang Gung University, Taoyuan, Taiwan; Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: I-Hao
authors.initials: IH
authors.lastname: Su
authors.affiliation: Chang Gung University, Taoyuan, Taiwan; Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Chien-Ming
authors.initials: CM
authors.lastname: Chen
authors.affiliation: Chang Gung University, Taoyuan, Taiwan; Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Sin-Yi
authors.initials: SY
authors.lastname: Lyu
authors.affiliation: Chang Gung University, Taoyuan, Taiwan; Department of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital, Linkou, Kweishan, Taoyuan, Taiwan. Electronic address: pjko@gmail.com.
authors.forename: Po-Jen
authors.initials: PJ
authors.lastname: Ko
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D017130:Angioplasty / Q000379:methods*; D001018:Aortic Diseases / Q000628:therapy*; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging* / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed