Single-Center Experience Following the Introduction of a Percutaneous Endovascular Aneurysm Repair First Approach

Area of Science:

• Vascular Surgery
• Interventional Cardiology
• Medical Device Technology

Background:

• Endovascular aneurysm repair (EVAR) has become a standard treatment for abdominal aortic aneurysms.
• A percutaneous endovascular aneurysm repair (pEVAR) first approach aims to minimize invasiveness.
• The Perclose Proglide device facilitates percutaneous closure of arteriotomies.

Purpose of the Study:

• To evaluate the efficacy and safety of a pEVAR first approach using Perclose Proglide.
• To identify factors predicting access site failure and complications.
• To assess the impact of patient anatomy on pEVAR outcomes.

Main Methods:

• Retrospective cohort study over a 2-year period.
• Inclusion of patients undergoing pEVAR with Perclose Proglide closure.
• Analysis of technical success, hemostasis, complications, and predictive factors.

Main Results:

• Technical success for pEVAR was 77.4% (41/53 patients).
• Successful access site hemostasis was achieved in 86.5% (83/96 sites).
• Smaller common femoral artery (CFA) diameter and >50% CFA calcification predicted failure (P=.045, P=.0001).
• Higher infection rates and longer procedure times were associated with pEVAR failure (P=.008, P=.026).

Conclusions:

• A pEVAR first approach should be implemented cautiously.
• Patient selection is crucial, as unfavorable access site anatomy predicts failure.
• Optimizing patient selection can improve pEVAR success rates and reduce complications.