Efficacy and safety of the preclose technique following percutaneous aortic stent-graft implantation

Purpose: To evaluate in a large patient cohort the 6-F Perclose ProGlide in conjunction with the preclose technique to seal puncture sites after percutaneous endovascular aortic repairs. Methods: The medical records were reviewed of 367 patients (303 men; mean age 68.5±10.8 years) having 599 access site closures with the 6-F Perclose ProGlide performed in conjunction with percutaneous endovascular aortic repairs. Procedure success was defined as hemostasis with the preclose technique without the need for any ancillary procedure. Access-related major adverse events included infection, bleeding, lower leg ischemia, hematoma, pseudoaneurysm, arteriovenous fistula, embolization, laceration, femoral artery thrombosis, nerve injury, or death owing to an access site injury. Results: Procedure success was achieved in 359 (97.8%) of 367 patients and in 591 (98.7%) of 599 femoral sites. Access-related major adverse events developed in 25 (6.8%) of 367 patients [26/599 (4.3%) sites]. The most frequent adverse event was a hematoma [16/367 (4.4%) patients; 17/599 (2.8% ) sites], followed by pseudoaneurysm [7/367 (1.9%) patients; 7/599 (1.2%) sites]. Bleeding occurred in 6 (1.6%) of 367 patients [6/599 (1.0%) sites]. There were 2 infections, 2 distal embolizations, 1 acute femoral thrombosis, and 1 laceration at the puncture site. Conclusion: The preclose technique can be used to achieve hemostasis with remarkable success and low rates of adverse events.