title: New surgical modification of fascial closure following endovascular aortic pathology repair.
abstract: BACKGROUND
  There are clear benefits of percutaneous versus open femoral access for endovascular aortic pathology repair. All closing devices commercially available are expensive. Surgical closure of the femoral artery risks potential prolonged wound healing and as a consequence longer hospital stay. Fascial closure is a technique that remains an interesting option.
  
  
  OBJECTIVE
  To evaluate the efficacy of the surgical modification of hemostasis control after endovascular repair of aortic pathology.
  
  
  METHODS
  One hundred sixteen common femoral arteries in a group of 58 patients underwent a minimally invasive procedure. Patients suffering from abdominal, thoracic aorta aneurysms, acute thoracic aorta type B dissections and traumatic aortic injury were treated.
  
  
  RESULTS
  A 1-year period of experience in fascial closure of 116 common femoral arteries was presented in the group of 58 patients undergoing endovascular interventions. Five intraoperative complications were observed and one late. Three primary failures were due to hemorrhage in three arteries, one required open repair and two additional compression after the procedure. Two cases of limb ischemia required surgical correction of artery closure. One limb ischemia was detected 4 weeks later, and was treated conservatively. At 1 year, 92 fascial closures (80%) were in the follow-up and 24 (20%) were lost to follow-up.
  
  
  CONCLUSIONS
  This new modification of fascial closure is a safe and cheap method of arterial closure following endovascular repair of selected aortic pathologies. The usage of two suture lines makes this procedure easy and quick. Fascial closure technique is comparable to other techniques in terms of success and complication rates.
authors.affiliation: Department of Vascular and Endovascular Surgery, Military Institute of Medicine, Warsaw, Poland.
authors.forename: Miroslaw
authors.initials: M
authors.lastname: Dziekiewicz
authors.affiliation: Second Department of Clinical Radiology, Warsaw Medical University, Poland.
authors.forename: Rafal
authors.initials: R
authors.lastname: Maciag
authors.affiliation: Department of Vascular and Endovascular Surgery, Military Institute of Medicine, Warsaw, Poland.
authors.forename: Marek
authors.initials: M
authors.lastname: Maruszynski
keywords: closing device; endovascular procedure; fascial closure
references.citation: J Vasc Surg. 2008 May;47(5):919-23
references.pmid: 18328666
references.citation: Semin Vasc Surg. 2012 Dec;25(4):208-16
references.pmid: 23206568
references.citation: Ann Vasc Surg. 2008 Nov;22(6):736-41
references.pmid: 18657384
references.citation: Eur J Vasc Endovasc Surg. 2004 Mar;27(3):319-23
references.pmid: 14760603
references.citation: J Endovasc Ther. 2009 Dec;16(6):708-13
references.pmid: 19995109
references.citation: J Cardiovasc Surg (Torino). 2010 Dec;51(6):791-8
references.pmid: 21124275
references.citation: J Endovasc Ther. 2006 Apr;13(2):152-7
references.pmid: 16643069
references.citation: Vasc Endovascular Surg. 2003 Mar-Apr;37(2):105-9
references.pmid: 12669141
references.citation: J Vasc Surg. 2003 Jul;38(1):78-82
references.pmid: 12844093
references.citation: J Vasc Surg. 2006 Feb;43(2):270-6
references.pmid: 16476600
references.citation: Eur J Vasc Endovasc Surg. 2011 Mar;41(3):346-9
references.pmid: 21145265