Aims and objectives
Detailed description of the use of percutaneous closure devices in femoral accesses during an EVAR intervention: steps,
technique and tips.
Study the index of technique success in all patients treated in the last 4 years in our center.
Study of the early complications due to the femoral closure device in this group of patients.
Demonstrate that percutaneous closure devices are agood alternative for the closure of femoral accesses in EVAR intervention.
Methods and materials
Vascular closure devices are in their third decade of development for diagnostic and interventional cardiovascular procedures.
The adoption of that kind of devices has ocurred because a clear technological feat: vascular closure devices reliably shortens the time of hemostasis (elapsed time between sheath removal and first observed hemostasis) compared with manual compression and thus allow earlier patient ambulation.
In front of another approaches,
femoral vascular closure can be performed inmediately at the end of the procedure regarless of anticoagulation status: procedural success is expected in...
Results
In our experience,
successful closure was achieved in 162 access sites (96%).
Three sites required additional measures to stop bleeding (manual compression) and in one of them there was a pseudoaneurysm at the femoral access.
In the case of the pseudoaneurysm,
it was less than 3 cm and did not produce symptoms,
so clinical controls were performed and it was resolved spontaneously.
Conclusion
Use of percutaneous closure device is a good alternative to surgical dissection in the femoral access,
with low rates of time of use of the x-ray room,
short stay time at the hospital and mínimum complications if a careful selection of the patients was made.
References
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Ganeshan A,
Thomas SM,
Warakaulle D,
Jagdish J,
Uberoi R.
Vascular closure devices: a comparative overview.
Curr Probl Diagn Radiol 2009; 38:33-43.
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Sieunarine K,
van Schie G,
Goodman MA,
Lawrence-Brown M,
Prendergast FJ,
Hartley D.
Use of the percutaneous vascular surgery device for closure of femoral access sites during endovascular aneurysm repair: lessons from our experience.
Eur J Vasc Endovasc Surg 2001; 22,
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- Howell M,
Villarreal R,
Krajcer Z.Percutaneous Access and Closure of Femoral Artery Access Sites...