Predictive Factors for Additional ProGlide Deployment in Percutaneous Endovascular Aortic Repair

Area of Science:

• Vascular Surgery
• Interventional Cardiology
• Medical Device Technology

Background:

• Percutaneous endovascular aortic repair (PEVAR) utilizes minimally invasive techniques for aortic disease treatment.
• Achieving adequate hemostasis at femoral access sites is critical for PEVAR success.
• The preclose technique with ProGlide devices aims to facilitate closure and reduce complications.

Purpose of the Study:

• To assess the outcomes of using additional ProGlide devices for hemostasis in PEVAR.
• To identify factors predicting the need for extra ProGlide device deployment during PEVAR procedures.
• To evaluate the impact of additional ProGlide deployment on surgical repair rates.

Main Methods:

• Retrospective review of 268 patients undergoing PEVAR (TEVAR, EVAR) with the preclose technique (Feb 2012-Jan 2015).
• Analysis of 418 femoral access sites, noting instances requiring additional ProGlide device deployment.
• Univariate and multivariate analyses to determine predictors of additional ProGlide use.

Main Results:

• Primary technical success with two ProGlide devices was 87.6%; 11.5% of sites needed additional ProGlide deployment.
• Secondary technical success reached 99.0%, with only 1.0% requiring surgical repair.
• Anterior common femoral artery (CFA) wall calcification significantly increased the odds of requiring additional ProGlide devices (aOR 6.19).

Conclusions:

• Additional ProGlide device deployment effectively reduces surgical repair rates following primary hemostasis failure in PEVAR.
• Anterior CFA wall calcification is a significant and independent predictor for the need for additional ProGlide device deployment.