Percutaneous closure of femoral artery access sites in endovascular stent-graft treatment of aortic disease

Chi Young Shim, Sungha Park, Young Guk Ko, Donghoon Choi, Yangsoo Jang, Won Heum Shim

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14 Citations (Scopus)

Abstract

Background: Endovascular techniques using various stent-graft systems are now available to treat aortic disease. Because stent-grafts need large-bore sheaths, arterial surgical cut-downs for access and closure are required. This study describes and reports the results of a percutaneous technique using multiple Perclose devices (Closer-S, 6 Fr) for large arteriotomy closure. Methods: Sixty-six patients (50 males; mean age 62.8 ± 11.8 years) with endovascular stent-graft treatment (from Feb. 2004 to Jan. 2006) were studied. A total of 92 femoral sites were required for large-bore (larger than 14 Fr) sheaths insertion. Stent-graft devices were introduced through 20 Fr (n = 8), 18 Fr (n = 29), 16 Fr (n = 29) or 14 Fr (n = 26) sheaths. After deployment of 2 or 3 Percloses (Closer-S, 6 Fr), arteriotomies were dilated to create an appropriate size for large-bore sheaths insertion. After stent-graft insertion, hemostasis was achieved using multiple Perclose sutures placed prior to arterial dilatation. All femoral sites were followed with physical examination and CT angiography. Results: Percutaneous closures with 2 or 3 Perclose devices were successful in 95.7% (88/92) of femoral sites, without complication of hematoma, infection, pseudoaneurysm, or arterial thromboses. In 4.3% (4/92), arterial complications requiring vascular surgical repair occurred. Conclusion: Percutaneous closure technique using 2 or 3 Perclose devices placed prior to arterial dilatation is useful for hemostasis in endovascular stent-graft treatment of aortic disease.

Original languageEnglish
Pages (from-to)251-254
Number of pages4
JournalInternational Journal of Cardiology
Volume130
Issue number2
DOIs
Publication statusPublished - 2008 Nov 12

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Aortic Diseases
Femoral Artery
Stents
Transplants
Thigh
Equipment and Supplies
Hemostasis
Dilatation
Therapeutics
Endovascular Procedures
False Aneurysm
Hematoma
Sutures
Physical Examination
Blood Vessels
Thrombosis
Infection

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

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title = "Percutaneous closure of femoral artery access sites in endovascular stent-graft treatment of aortic disease",
abstract = "Background: Endovascular techniques using various stent-graft systems are now available to treat aortic disease. Because stent-grafts need large-bore sheaths, arterial surgical cut-downs for access and closure are required. This study describes and reports the results of a percutaneous technique using multiple Perclose devices (Closer-S, 6 Fr) for large arteriotomy closure. Methods: Sixty-six patients (50 males; mean age 62.8 ± 11.8 years) with endovascular stent-graft treatment (from Feb. 2004 to Jan. 2006) were studied. A total of 92 femoral sites were required for large-bore (larger than 14 Fr) sheaths insertion. Stent-graft devices were introduced through 20 Fr (n = 8), 18 Fr (n = 29), 16 Fr (n = 29) or 14 Fr (n = 26) sheaths. After deployment of 2 or 3 Percloses (Closer-S, 6 Fr), arteriotomies were dilated to create an appropriate size for large-bore sheaths insertion. After stent-graft insertion, hemostasis was achieved using multiple Perclose sutures placed prior to arterial dilatation. All femoral sites were followed with physical examination and CT angiography. Results: Percutaneous closures with 2 or 3 Perclose devices were successful in 95.7{\%} (88/92) of femoral sites, without complication of hematoma, infection, pseudoaneurysm, or arterial thromboses. In 4.3{\%} (4/92), arterial complications requiring vascular surgical repair occurred. Conclusion: Percutaneous closure technique using 2 or 3 Perclose devices placed prior to arterial dilatation is useful for hemostasis in endovascular stent-graft treatment of aortic disease.",
author = "Shim, {Chi Young} and Sungha Park and Ko, {Young Guk} and Donghoon Choi and Yangsoo Jang and Shim, {Won Heum}",
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T1 - Percutaneous closure of femoral artery access sites in endovascular stent-graft treatment of aortic disease

AU - Shim, Chi Young

AU - Park, Sungha

AU - Ko, Young Guk

AU - Choi, Donghoon

AU - Jang, Yangsoo

AU - Shim, Won Heum

PY - 2008/11/12

Y1 - 2008/11/12

N2 - Background: Endovascular techniques using various stent-graft systems are now available to treat aortic disease. Because stent-grafts need large-bore sheaths, arterial surgical cut-downs for access and closure are required. This study describes and reports the results of a percutaneous technique using multiple Perclose devices (Closer-S, 6 Fr) for large arteriotomy closure. Methods: Sixty-six patients (50 males; mean age 62.8 ± 11.8 years) with endovascular stent-graft treatment (from Feb. 2004 to Jan. 2006) were studied. A total of 92 femoral sites were required for large-bore (larger than 14 Fr) sheaths insertion. Stent-graft devices were introduced through 20 Fr (n = 8), 18 Fr (n = 29), 16 Fr (n = 29) or 14 Fr (n = 26) sheaths. After deployment of 2 or 3 Percloses (Closer-S, 6 Fr), arteriotomies were dilated to create an appropriate size for large-bore sheaths insertion. After stent-graft insertion, hemostasis was achieved using multiple Perclose sutures placed prior to arterial dilatation. All femoral sites were followed with physical examination and CT angiography. Results: Percutaneous closures with 2 or 3 Perclose devices were successful in 95.7% (88/92) of femoral sites, without complication of hematoma, infection, pseudoaneurysm, or arterial thromboses. In 4.3% (4/92), arterial complications requiring vascular surgical repair occurred. Conclusion: Percutaneous closure technique using 2 or 3 Perclose devices placed prior to arterial dilatation is useful for hemostasis in endovascular stent-graft treatment of aortic disease.

AB - Background: Endovascular techniques using various stent-graft systems are now available to treat aortic disease. Because stent-grafts need large-bore sheaths, arterial surgical cut-downs for access and closure are required. This study describes and reports the results of a percutaneous technique using multiple Perclose devices (Closer-S, 6 Fr) for large arteriotomy closure. Methods: Sixty-six patients (50 males; mean age 62.8 ± 11.8 years) with endovascular stent-graft treatment (from Feb. 2004 to Jan. 2006) were studied. A total of 92 femoral sites were required for large-bore (larger than 14 Fr) sheaths insertion. Stent-graft devices were introduced through 20 Fr (n = 8), 18 Fr (n = 29), 16 Fr (n = 29) or 14 Fr (n = 26) sheaths. After deployment of 2 or 3 Percloses (Closer-S, 6 Fr), arteriotomies were dilated to create an appropriate size for large-bore sheaths insertion. After stent-graft insertion, hemostasis was achieved using multiple Perclose sutures placed prior to arterial dilatation. All femoral sites were followed with physical examination and CT angiography. Results: Percutaneous closures with 2 or 3 Perclose devices were successful in 95.7% (88/92) of femoral sites, without complication of hematoma, infection, pseudoaneurysm, or arterial thromboses. In 4.3% (4/92), arterial complications requiring vascular surgical repair occurred. Conclusion: Percutaneous closure technique using 2 or 3 Perclose devices placed prior to arterial dilatation is useful for hemostasis in endovascular stent-graft treatment of aortic disease.

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