Vascular SurgeryUnit, Department of Cardiothoracic and Vascular Surgery, University Hospital of Heraklion, Crete, Greece.
Interventional Radiology Unit, Department of Radiology, University Hospital of Heraklion, Crete, Greece.
Ann Vasc Surg. 2021 May;73:496-499. doi: 10.1016/j.avsg.2021.01.080. Epub 2021 Feb 5.
Percutaneous endovascular aneurysm repair (EVAR) and peripheral interventions using the Perclose Proglide suture mediated system has not been adequately studied in patients with synthetic grafts at access sites.
We report the use of the Perclose Proglide in 10 patients in whom previously inserted synthetic grafts in the groin were punctured for arterial access (5 for peripheral interventions and 5 undergoing EVAR). In patients undergoing peripheral interventions a single device was used, while in patients undergoing EVAR 2 devices were employed per access site. The preclosing technique was used in every case.
Hemostasis was achieved in all patients. No complications were observed except for a small laceration and a localized hemodynamically nonsignificant stenosis, without any clinical sequel.
This small case series indicates the feasibility of percutaneous access with the Perclose Proglide system to perform EVAR and peripheral endovascular interventions in the presence of synthetic grafts in the groin, with promising outcomes.
在股部有合成移植物的患者中，经皮血管内动脉瘤修复术（EVAR）和使用 Perclose Proglide 缝合介导系统的外周介入治疗尚未得到充分研究。
我们报告了在 10 例患者中使用 Perclose Proglide 的情况，这些患者的股部先前插入了合成移植物以进行动脉入路（5 例用于外周介入治疗，5 例用于 EVAR）。在接受外周介入治疗的患者中，使用了单个装置，而在接受 EVAR 的患者中，每个入路部位使用了 2 个装置。在所有情况下均使用预闭合技术。
所有患者均实现止血。除了小的撕裂伤和局部血流动力学无显著狭窄外，未观察到任何并发症，且无任何临床后遗症。
这个小的病例系列表明，在股部有合成移植物的情况下，使用 Perclose Proglide 系统进行经皮入路是可行的，可以进行 EVAR 和外周血管内介入治疗，结果有一定前景。
