A Real-World Experience Comparison of Percutaneous and Open Femoral Exposure for Endovascular Abdominal Aortic Aneurysm Repair in a Tertiary Medical Center

Mukherjee, Dipankar; Emery, Erica; Majeed, Rashad; Heshmati, Keyvan; Hashemi, Homayoun

doi:10.1177/1538574417702774

Cited by 6 publications

(3 citation statements)

References 7 publications

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“…The authors then performed two analyses on the occurrence of hematoma including Northside Medical Center and OVER study and the mortality rate associated with EVAR including Northside Medical Center and OVER study [7]. Current literature suggests that Percutaneous access to the femoral artery with ultrasound guidance is more advantageous than open surgical repair in the management of aortic aneurysms [3,4,13]. In a retrospective study collecting prospective clinical data from the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database, Buck et al identified 3004 patients with open surgical repair and 1108 patients undergoing Percutaneous access [4].…”

Section: Discussionmentioning

confidence: 99%

Comparing and Correlating Outcomes between Open and Percutaneous Access in Endovascular Aneurysm Repair in Aortic Aneurysms Using a Retrospective Cohort Study Design

DeVito

Kimyaghalam

Shoukry

et al. 2020

International Journal of Vascular Medicine

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Objective. This retrospective cohort study is aimed at determining the safety and efficacy between Femoral Open-Cutdown access and Percutaneous access with Endovascular Aneurysm Repair (EVAR) by contrasting perioperative complication rates. We hypothesized that the percutaneous approach is a better alternative for aortic aneurysm patients as it is minimally invasive and has been demonstrated to decrease the length of hospital stay. Methods. We retrospectively reviewed data for patients undergoing EVAR between the years of 2005 and 2013. We then compared overall mortality, hematoma or seroma formation, graft infection, arterio-venous injury, distal embolization, limb loss, myocardial infarction or arrhythmia, and renal dysfunction. Results were demonstrated using a retrospective cohort study design to confirm the hematoma rate associated with EVAR open compared to percutaneous access. Results. Our series involves 73 patients who underwent percutaneous access for EVAR ( n = 49 ) or traditional open cutdown ( n = 24 ). Percutaneous access resulted in significantly less hematoma formation when compared to the traditional open cutdown (4% vs. 12.5%; p < 0.059 ). Our analysis suggests decreased mortality rates associated with EVAR as compared to the Open-Cutdown method using Northside Medical Center’s Study and the OVER Veterans Affairs Cooperative Study ( p = 0.0053 ). Conclusion. Percutaneous access for EVAR is safe and effective when compared to Open-Cutdown access for aortic aneurysm patients. Percutaneous access was associated with decreased rates of in-hospital mortality, hematoma formation, graft infection, and respiratory failure.

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Section: Discussionmentioning

confidence: 99%

Comparing and Correlating Outcomes between Open and Percutaneous Access in Endovascular Aneurysm Repair in Aortic Aneurysms Using a Retrospective Cohort Study Design

DeVito

Kimyaghalam

Shoukry

et al. 2020

International Journal of Vascular Medicine

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“…17 , 18 Mukherjee et al. 19 demonstrated that percutaneous approach had even less complications rates when compared to surgical approach. Percutaneous closure devices are not only used for endovascular interventions but also widely and safely used in aortic interventions.…”

Section: Discussionmentioning

confidence: 99%

Comparison between PeRcutanEous and surgical femoral aCcess for endovascuLar aOrtic repair in patientS with typE III aortic Dissection (PRECLOSE Trial)

et al. 2020

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Objectives Aortic dissections are cardiovascular events with high mortality and morbidity rates. Management might be either with medical or interventional approach. Recently, thoracic endovascular intervention (TEVAR) becomes the first treatment of choice because of its better results and lower rates of complications in patients with type III aortic dissections. The intervention might be performed via femoral artery either with percutaneous or with surgical approach. Because of large sheath insertion to femoral artery, Pre-close technique is described in literature. The aim of this study was to investigate and compare the outcomes and safety of ‘Pre-close technique’ to surgical approach in patients with type III aortic dissections who underwent TEVAR with femoral access ≥22 F. Methods A total of 96 patients whom had type III aortic dissection and was performed TEVAR were retrospectively included in the study. Fifty-six patients had TEVAR with percutaneous approach and these patients are named as P-TEVAR group, and 40 patients had TEVAR with surgical approach and these patients are named as S-TEVAR group. Pre- and post-procedural data with complications and procedural data during TEVAR were evaluated for both groups and compared in between. Results The main finding was that there was no significant difference between S-TEVAR and P-TEVAR groups in terms of complications and technical success. Operating room time was significantly decreased in P-TEVAR group ( P < 0.001). Overall success rate for femoral approach in patients with Pre-close technique was 94.6% and was 100% for surgical approach. P-TEVAR group had post-operative complications in three patients and S-TEVAR group had in four patients. Conclusions Total percutaneous approach with Pre-close technique using Pro-Glide device is a safe and feasible method of femoral access in patients with type III aortic dissections.

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“…The cut-down method allows for complete visualisation of the femoral vessels, but takes longer and is associated with groin wound complications as seen following endovascular aortic aneurysm repair, the percutaneous approach for endovascular access is now favoured in most cases. [30][31] This study is limited by the use of cadaveric specimens which assume a 'fixed' anatomical position after embalming and were free from trauma that would have otherwise distorted the anatomy. It is conceivable that within the context of multisystem trauma whereby injuries are sustained to the trunk and lower limbs simultaneously, a blind landmark-based technique such as the one proposed may be less effective.…”

Section: Discussionmentioning

confidence: 99%

The REBOA window: a cadaveric study delineating the optimum site for austere cannulation of the femoral artery for resuscitative endovascular balloon occlusion of the aorta

et al. 2020

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IntroductionHaemorrhage is the major cause of early mortality following traumatic injury. Patients suffering from non-compressible torso haemorrhage are more likely to suffer early death. Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) can be effective in initial resuscitation; however, establishing swift arterial access is challenging, particularly in a severe shock. This is made more difficult by anatomical variability of the femoral vessels.MethodsThe femoral vessels were characterised in 81 cadaveric lower limbs, measuring specifically the distance from the inferior border of the inguinal ligament to the distal part of the origin of the profunda femoris artery (PFA), and from the distal part of the origin of the PFA to where the femoral vein lies posterior to and is completely overlapped by the femoral artery.ResultsThe femoral vein lay deep to the femoral artery at a mean distance of 105 mm from the inferior border of the inguinal ligament. The PFA arose from the femoral artery at a mean distance of 51.1 mm from the inguinal ligament. From the results, it is predicted that the PFA originates from the common femoral artery approximately 24 mm from the inguinal ligament, and the femoral vein is completely overlapped by the femoral artery by 67.7 mm distal from the inguinal ligament, in 95% of subjects.ConclusionsBased on the results, proposed is an ‘optimal access window’ of up to 24 mm inferior to the inguinal ligament for common femoral arterial catheterisation for pre-hospital REBOA, or more simply within one finger breadth.

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A Real-World Experience Comparison of Percutaneous and Open Femoral Exposure for Endovascular Abdominal Aortic Aneurysm Repair in a Tertiary Medical Center

Cited by 6 publications

References 7 publications

Comparing and Correlating Outcomes between Open and Percutaneous Access in Endovascular Aneurysm Repair in Aortic Aneurysms Using a Retrospective Cohort Study Design

Comparing and Correlating Outcomes between Open and Percutaneous Access in Endovascular Aneurysm Repair in Aortic Aneurysms Using a Retrospective Cohort Study Design

Comparison between PeRcutanEous and surgical femoral aCcess for endovascuLar aOrtic repair in patientS with typE III aortic Dissection (PRECLOSE Trial)

The REBOA window: a cadaveric study delineating the optimum site for austere cannulation of the femoral artery for resuscitative endovascular balloon occlusion of the aorta

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