Safety and Effectiveness of the Single Perclose Method with Large-Bore Sheaths

This study aimed to evaluate the safety and effectiveness of percutaneous endovascular aortic repair (pEVAR) using a single Perclose with large-bore sheaths, including bore sheaths of 20 Fr or over.

A retrospective cohort study was conducted on all percutaneous endovascular aortic repair performed between September 2023 and April 2025. A total of 78 patients, 54 with abdominal aortic aneurysms and 24 with thoracic aortic aneurysms, were included. Preoperative and postoperative computed tomography examinations were used to evaluate the access site or access route, including femoral artery diameter, calcification, access route tortuosity, and distance from the body surface to the femoral artery. The outcome measures were the technical success rate of access site closure with the Perclose device, vascular complications at the access site, and access route, based on the Valve Academic Research Consortium 3 criteria.

A total of 132 access sites were closed, 72 with the single Perclose method using a Perclose ProStyle device and 60 with a double Perclose method using 2 Perclose ProStyle devices. There were no significant differences between the single and double Perclose methods in the assessment of preoperative patient characteristics or access route. Large-diameter sheaths of 20 Fr or over were used in 16.7% of the single Perclose methods. The technical success rate of access site closure was 98.6% using the single Perclose method, 95.0% using the double Perclose method, and 97.0% overall. The vascular complications occurred in only 2 cases with the double Perclose method, and no complications were noted with the single Perclose method. The single Perclose method was not identified as a risk factor for Perclose failure.

Like the double Perclose method, the single Perclose method with large-diameter sheaths of 20 Fr or over may be a safe and feasible access site closure method for percutaneous endovascular aortic repair.