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Short- and midterm results of the fascia suture technique for closure of femoral artery access sites after endovascular aneurysm repair.

Montan, Carl LU ; Lehti, Leena; Holst, Jan LU ; Björses, Katarina LU and Resch, Timothy A (2011) In Journal of Endovascular Therapy 18(6). p.789-796
Abstract
Abstract Purpose: To evaluate the midterm outcomes and potential risk factors associated with the fascia suture technique (FST) for closure of femoral artery access sites after percutaneous endovascular aneurysm repair (EVAR). Methods: Between April 2007 and April 2008, 100 consecutive EVAR cases were evaluated retrospectively. A third of the procedures were emergent (16 ruptured aneurysms). Of the 187 femoral access sites, 160 (85.5%) were closed by the FST as a first choice. Pre- and postoperative chart and imaging data were collected from computerized medical records for analysis of demographics and the rate of complications (bleeding, infection, thrombosis, pseudoaneurysms, and stenosis). Preoperative risk factors for FST failure were... (More)
Abstract Purpose: To evaluate the midterm outcomes and potential risk factors associated with the fascia suture technique (FST) for closure of femoral artery access sites after percutaneous endovascular aneurysm repair (EVAR). Methods: Between April 2007 and April 2008, 100 consecutive EVAR cases were evaluated retrospectively. A third of the procedures were emergent (16 ruptured aneurysms). Of the 187 femoral access sites, 160 (85.5%) were closed by the FST as a first choice. Pre- and postoperative chart and imaging data were collected from computerized medical records for analysis of demographics and the rate of complications (bleeding, infection, thrombosis, pseudoaneurysms, and stenosis). Preoperative risk factors for FST failure were analyzed with regard to obesity (based on the subcutaneous fat layer), plaque at the femoral access site, and stenosis based on the pre- and 1-year postoperative computed tomography scans. Results: Of the 160 FST closures, 146 (91.3%) were technically successful. The 14 (8.8%) technical failures were converted to open cutdown intraoperatively because of bleeding (11, 6.8%), inadequate limb perfusion (2, 1.2%), and a broken guidewire (1, 0.6%). Two (1.2%) pseudoaneurysms required surgical repair after 2 weeks. Data from the 1-year follow-up showed no signs of increased stenosis, thrombosis, or formation of plaque. Nine small (<1 cm(3)) pseudoaneurysms were detected and managed conservatively. No preoperative risk factors were associated with FST failure. Conclusion: The fascia suture technique seems to be safe, effective, and simple to use for closing percutaneous access sites after EVAR. Complications are rare, and the outcome is not affected by obesity, femoral calcification, or femoral artery stenosis. (Less)
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author
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type
Contribution to journal
publication status
published
subject
in
Journal of Endovascular Therapy
volume
18
issue
6
pages
789 - 796
publisher
International Society of Endovascular Specialists
external identifiers
  • wos:000297971700011
  • pmid:22149228
  • scopus:83455172441
ISSN
1545-1550
DOI
10.1583/11-3621.1
language
English
LU publication?
yes
id
8fc7c77e-6ee2-41c2-a397-942c4fd2a65b (old id 2274355)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/22149228?dopt=Abstract
date added to LUP
2012-01-03 16:31:58
date last changed
2017-01-01 07:32:37
@article{8fc7c77e-6ee2-41c2-a397-942c4fd2a65b,
  abstract     = {Abstract Purpose: To evaluate the midterm outcomes and potential risk factors associated with the fascia suture technique (FST) for closure of femoral artery access sites after percutaneous endovascular aneurysm repair (EVAR). Methods: Between April 2007 and April 2008, 100 consecutive EVAR cases were evaluated retrospectively. A third of the procedures were emergent (16 ruptured aneurysms). Of the 187 femoral access sites, 160 (85.5%) were closed by the FST as a first choice. Pre- and postoperative chart and imaging data were collected from computerized medical records for analysis of demographics and the rate of complications (bleeding, infection, thrombosis, pseudoaneurysms, and stenosis). Preoperative risk factors for FST failure were analyzed with regard to obesity (based on the subcutaneous fat layer), plaque at the femoral access site, and stenosis based on the pre- and 1-year postoperative computed tomography scans. Results: Of the 160 FST closures, 146 (91.3%) were technically successful. The 14 (8.8%) technical failures were converted to open cutdown intraoperatively because of bleeding (11, 6.8%), inadequate limb perfusion (2, 1.2%), and a broken guidewire (1, 0.6%). Two (1.2%) pseudoaneurysms required surgical repair after 2 weeks. Data from the 1-year follow-up showed no signs of increased stenosis, thrombosis, or formation of plaque. Nine small (&lt;1 cm(3)) pseudoaneurysms were detected and managed conservatively. No preoperative risk factors were associated with FST failure. Conclusion: The fascia suture technique seems to be safe, effective, and simple to use for closing percutaneous access sites after EVAR. Complications are rare, and the outcome is not affected by obesity, femoral calcification, or femoral artery stenosis.},
  author       = {Montan, Carl and Lehti, Leena and Holst, Jan and Björses, Katarina and Resch, Timothy A},
  issn         = {1545-1550},
  language     = {eng},
  number       = {6},
  pages        = {789--796},
  publisher    = {International Society of Endovascular Specialists},
  series       = {Journal of Endovascular Therapy},
  title        = {Short- and midterm results of the fascia suture technique for closure of femoral artery access sites after endovascular aneurysm repair.},
  url          = {http://dx.doi.org/10.1583/11-3621.1},
  volume       = {18},
  year         = {2011},
}