Current Status of Percutaneous Endografting

Area of Science:

• Vascular Surgery
• Endovascular Interventions
• Aortic Aneurysm Repair

Background:

• Totally percutaneous endovascular abdominal aortic aneurysm repair (PEVAR) offers advantages over open surgery, including less invasiveness and quicker hemostasis.
• Recent interest focuses on expanding PEVAR to patients with challenging anatomy, such as calcified or small common femoral arteries.

Purpose of the Study:

• To assess the safety and efficacy of PEVAR compared to standard open femoral exposure.
• To evaluate PEVAR in a multicenter randomized controlled trial setting.

Main Methods:

• The study involved a multicenter randomized controlled trial comparing PEVAR with standard open femoral exposure.
• Suture-mediated closure devices (SMCDs) were utilized for percutaneous access.

Main Results:

• PEVAR was demonstrated to be safe, effective, and noninferior to open femoral exposure in trained operators.
• Percutaneous access resulted in shorter procedures, faster hemostasis, and enhanced patient quality of life.

Conclusions:

• PEVAR is a viable and effective alternative to open surgery for abdominal aortic aneurysm repair.
• Adherence to strict procedural techniques and careful patient selection are crucial for successful PEVAR outcomes, even in complex cases.