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

Area of Science:

• Vascular Surgery
• Interventional Cardiology
• Medical Device Technology

Background:

• Percutaneous endovascular aortic repair (pEVAR) is a minimally invasive procedure for treating aortic aneurysms.
• Large-bore sheaths are often required for pEVAR, posing challenges for vascular access site closure.
• The Perclose device is a commonly used method for achieving hemostasis at the access site.

Purpose of the Study:

• To evaluate the safety and effectiveness of using a single Perclose device for vascular access site closure in pEVAR procedures.
• To assess the feasibility of employing large-bore sheaths (≥20 Fr) with a single Perclose device for pEVAR.
• To compare the outcomes of single Perclose closure versus double Perclose closure in pEVAR.

Main Methods:

• Retrospective cohort study of 78 patients undergoing pEVAR between September 2023 and April 2025.
• Inclusion of patients with abdominal and thoracic aortic aneurysms.
• Evaluation of access site characteristics (femoral artery diameter, calcification, tortuosity) and closure outcomes (technical success, vascular complications) using Valve Academic Research Consortium 3 criteria.

Main Results:

• A total of 132 access sites were analyzed, with 72 closed using the single Perclose method and 60 using the double Perclose method.
• Large-bore sheaths (≥20 Fr) were used in 16.7% of single Perclose closures.
• The single Perclose method achieved a technical success rate of 98.6% with no reported vascular complications, compared to 95.0% success and 2 complications with the double Perclose method.

Conclusions:

• The single Perclose method is a safe and feasible approach for vascular access site closure in pEVAR, even with large-bore sheaths (≥20 Fr).
• This technique offers comparable safety and effectiveness to the double Perclose method.
• The findings support the expanded use of single Perclose closure for complex pEVAR cases requiring large-diameter access devices.