Percutaneous Approach in Endovascular Aortic Procedures Using a Suture-Mediated Closure Device

Area of Science:

• Vascular Surgery
• Interventional Cardiology
• Medical Device Technology

Background:

• Percutaneous endovascular aortic repair (EVAR) offers a less invasive approach to treating aortic pathologies.
• Achieving reliable hemostasis at the femoral access site is crucial for the success of EVAR procedures.
• Suture-mediated closure devices aim to provide rapid and secure hemostasis, facilitating percutaneous access.

Purpose of the Study:

• To evaluate the efficacy and technical success of the Perclose ProGlide closure device during percutaneous endovascular aortic repair (EVAR).
• To assess intraoperative and postoperative inguinal and vascular complications associated with the ProGlide device in EVAR procedures.

Main Methods:

• A retrospective analysis of patients undergoing EVAR via percutaneous femoral access between April 2017 and June 2021.
• The study analyzed 376 punctures in 263 patients using the Perclose ProGlide vascular closure system.
• Primary endpoints included technical success and efficacy; secondary endpoints focused on perioperative complications.

Main Results:

• The ProGlide system achieved a primary technical success rate of 93.1% and a secondary technical success rate of 94.7%.
• Intraoperative complications requiring femoral exposure occurred in 5.3% of cases, and postoperative complications in 3.5%.
• Larger sheath diameters and percutaneous re-puncture did not significantly increase complication rates or decrease success rates.

Conclusions:

• The ProGlide closure system is a safe and effective method for achieving hemostasis in percutaneous EVAR.
• This closure system is suitable for complex aortic pathologies, including those requiring staged procedures and re-puncture.