Percutaneous Thoracic and Abdominal Aortic Aneurysm Repair: Techniques and Outcomes

Abstract

Endovascular repair of infrarenal abdominal aortic aneurysms (EVAR) has become a widely accepted treatment modality. The conventional approach of an EVAR involves bilateral groin incisions to expose the femoral arteries followed by introducer sheath placement, which is typically performed with the use of general or epidural anesthesia. As technology trends toward less invasive methods and sheath sizes become smaller, the use of a total percutaneous approach to endovascular repair of aortic pathology is becoming more common. In this review, we present a brief history of percutaneous closure devices for common femoral artery access, factors important in patient selection, the technique of performing a percutaneous EVAR procedure, early and late complications, and overall outcomes of percutaneous approaches for the endovascular treatment of aortic pathology.

Suture‐mediated arterial access site closure after transfemoral aortic valve implantation

“…This complex mechanism implies not only a steep learning curve but also severe potential complications. An inability to capture the needles, for example, may result in the entrapment of the device in the arterial wall, necessitating surgical removal . In addition, Prostar XL™ failure is not uncommon.…”

Percutaneous Zenith Endografting for Abdominal Aortic Aneurysms

“…Frequently, this complication requires open surgical repair and in severe cases mandates wide debridement and extra-anatomic revascularization. 14,15 In a recent series by Lee et al, 19 of the 156 femoral arteries repaired, there were 3 late complications including one asymptomatic femoral artery dissection and two femoral artery pseudoaneurysms requiring surgical repair. This resulted in a late complication rate of 1.92%, which supports the relative low incidence of late complications associated with this form of closure.…”

Efficacy and Safety of Augmenting the Preclose Technique with a Collagen-Based Closure Device for Percutaneous Endovascular Aneurysm Repair

“…The preclose technique has been well described in the literature with minor variations [7,12,13]. The preclose technique with two Proglide devices is the method we routinely use in our institution and is briefly described.…”