title: Predictors and treatments of Proglide-related complications in percutaneous endovascular aortic repair.
abstract: OBJECTIVE
  To investigate the predictors and treatment of the 6-Fr Perclose Proglide-related complications (PRC) in percutaneous endovascular aortic repair (pEVAR).
  
  
  METHODS
  We retrospectively analyzed the PRC after pEVAR for the treatment of aortic aneurysm or dissection in our center from December 2012 to November 2013. Procedure success was defined as effective functioning of the two devices and local hemostasis. Access-related adverse events included vascular complications and device failures. Operative data and angiographic and computed tomography images were collected to assess the complications and treatment strategy.
  
  
  RESULTS
  A total of 198 patients with 275 puncture sites underwent pEVAR with the 6-Fr Perclose Proglide. The procedure was successful in 178 patients (89.9%), whereas PRC occurred in 20 cases (10.1%), including 10 device failures and 10 vascular complications. An extra manual ancillary compression was conducted in 7 patients, one more device was used in 8 patients, and surgical repair of the femoral artery was performed in 5 patients. PRC had a tendency to occur in patients with body mass index (BMI)>30 kg/m2 (p = 0.021), thoracic stent grafts (p = 0.038), common femoral artery (CFA) calcification (p = 0.001), CFA depth>4 cm (p = 0.001), and sheath size>20Fr (p = 0.005). Device failure-related mortality was zero. None of the access sites had complications during the midterm follow-up.
  
  
  CONCLUSIONS
  The pre-close technique with 6-Fr Perclose Proglide devices for pEVAR appears to be safe and effective with low technical failure and complication rates. Careful patient selection and proficiency in device manipulation might reduce the device related complications.
authors.affiliation: Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Guohua
authors.initials: G
authors.lastname: Hu
authors.affiliation: Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Chen
authors.affiliation: Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Weiguo
authors.initials: W
authors.lastname: Fu
authors.affiliation: Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Xu
authors.affiliation: Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Daqiao
authors.initials: D
authors.lastname: Guo
authors.affiliation: Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Junhao
authors.initials: J
authors.lastname: Jiang
authors.affiliation: Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Jue
authors.initials: J
authors.lastname: Yang
authors.affiliation: Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Yuqi
authors.initials: Y
authors.lastname: Wang
mesh_terms: D001011:Aorta / Q000601:surgery*; D057510:Endovascular Procedures / Q000009:adverse effects* / Q000295:instrumentation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology* / Q000628:therapy*; D011677:Punctures; D012189:Retrospective Studies