title: Single-Center Experience Following the Introduction of a Percutaneous Endovascular Aneurysm Repair First Approach.
abstract: We evaluated our experience following the introduction of a percutaneous endovascular aneurysm repair (pEVAR) first approach using Perclose Proglide assessing efficacy, complications, and identification of factors that could predict failure. A retrospective cohort study on patients over a 2-year period following the introduction of a pEVAR first approach was performed. The primary end point was defined as successful deployment and access site hemostasis. Percutaneous EVAR was technically successful in 41 (77.4%) of 53 patients and 83 (86.5%) of 96 access sites. Factors associated with failure were smaller common femoral artery (CFA) diameter ( P = .045) and CFA circumferential calcification of greater than 50% ( P = .0001). The incidence of access site infection was significantly higher in the failure group ( P = .008) as was procedure duration ( P = .026). Percutaneous EVAR first approach must be introduced with caution. Percutaneous EVAR failure occurs more often in patients with unfavorable access site anatomy. Success rate can be improved with careful patient selection.
authors.affiliation: 1 Department of Vascular and Endovascular Surgery, University Hospital of South Manchester, Manchester, United Kingdom.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Ashrafi
authors.affiliation: 1 Department of Vascular and Endovascular Surgery, University Hospital of South Manchester, Manchester, United Kingdom.
authors.forename: Qusai
authors.initials: Q
authors.lastname: Al-Jarrah
authors.affiliation: 1 Department of Vascular and Endovascular Surgery, University Hospital of South Manchester, Manchester, United Kingdom.
authors.forename: Mayooreshan
authors.initials: M
authors.lastname: Anandarajah
authors.affiliation: 1 Department of Vascular and Endovascular Surgery, University Hospital of South Manchester, Manchester, United Kingdom.
authors.forename: Ray
authors.initials: R
authors.lastname: Ashleigh
authors.affiliation: 1 Department of Vascular and Endovascular Surgery, University Hospital of South Manchester, Manchester, United Kingdom.
authors.forename: Mark
authors.initials: M
authors.lastname: Welch
authors.affiliation: 1 Department of Vascular and Endovascular Surgery, University Hospital of South Manchester, Manchester, United Kingdom.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Baguneid
mesh_terms: D000368:Aged; D000783:Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D000072226:Computed Tomography Angiography; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D006488:Hemostasis, Surgical; D006801:Humans; D015994:Incidence; D008297:Male; D018579:Patient Selection; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
keywords: aneurysm; perclose proglide; percutaneous EVAR