Learning objectives
To demonstrate the results can be achieved after endovascular abdominal and thoracic aortic repair (EVAR, TEVAR) with stentgraft implantations in local anesthesia via percutaneous approach.
Background
Aretrospective review was conducted of 61 consecutive patients (49 men; mean age 53,4 years) who underwent endovascular aortic aneurysm repair from December 2008 to September 2009. In this population, 32 (52,5%) patients were treated with EVAR and 29 (47,5%) with TEVAR. Of the 29 thoracic aortic aneurysms (TAA), 7 traumatic TAA, 5 acute Stanford B disections, 7 chronic Stanford B disections, 9 degenerative TAA and 1 false TAA after operation of coarctation were treated with various types of stentgrafts. Stentgrafts were inserted under the local...
Imaging findings OR Procedure details
PEVAR steps I-III (see Figures): A 10F closure device is advanced into the CFA in the usual fashion until adequate blood marking is achieved through the dedicated marker lumen, indicating the sutures and needles are within the vessel lumen (Fig. 1; number 1-3). Four needles are then deployed, and the sutures are removed from the hub, taking care to identify the upper and lower sets of sutures, which are are not tied (Fig. 1,2; number 4-5). The device is than slowly retracted and a 0.038-inch...
Conclusion
Given appropriate volume and skill sets percutaneous endovascular EVAR and TEVAR in local anesthesia can provide nowadays the lowest invasive method of managing aortic diseases with very rare perioparative morbidity and mortality.
Personal Information
Contact adress:Ivan Vulev, MD, PhD.Department of Diagnostic and Interventional RadiologyNational Institute of Cardiovascular DiseasesPod Krásnou Hôrkou 183848 Bratislava 37, SlovakiaTel. +421 2 59 320298Email:
[email protected]
References
1. Gerckens U, Caatelaens N, Muller R. Percutaneous suture of femoral artery access sites after diagnostic heart catheterization and or coronary intervention. Safety and effectiveness of a new arterial suture technique. Herz. 1998;23:27–34.2. Hoffinan K, Schott UG, Erb M. Remote suturing for percutaneous closure of popliteal artery access site. Cathet Cardiovasc Diagn. 1998;43:421–427.3. Duda SH, Wiskirchen J, Erb M. Suture-mediated closure of antegrade femoral arterial access sites in patients who have received full anticoagulation therapy. Radiology. 1999;210:47–52.4. Baim D, Pinkerton C, Vetter J. Acute results...
