Safety and Efficacy of Totally Percutaneous Access Compared With Open Femoral Exposure for Endovascular Aneurysm Repair

Abstract

PEVAR had a similar technical success rate, shorter procedure time, and lower complication rate compared with OFA. Thus, percutaneous access appears to be the preferential approach for EVAR. However, larger and randomized studies are needed to draw definitive conclusions.

Access Type for Endovascular Repair in Ruptured Abdominal Aortic Aneurysms Does Not Affect Major Morbidity or Mortality

“…8 Additional meta-analyses confirmed that percutaneous access, compared with open access, was associated with decreased likelihood for any access-related complications such as surgical site infection, pseudoaneurysm, seroma, and lymphocele. 11,17 Thus, our findings further encourage the use of percutaneous access, particularly in emergent cases such as for ruptured AAAs.…”

Long-Term Evaluation of Percutaneous Groin Access for EVAR

“…Several studies have shown PEVAR to have both a shorter operating time and shorter length of stay compared to open surgical access [ 4 , 7 ]. Technical success rates vary between 86 and 94% [ 8 – 11 ].…”

“…The most common immediate complication is bleeding from access vessels as a result of arterial damage related to passage of the access sheath or closure device systems. Short-term complications of groin access include groin infections, nerve injury, pseudoaneurysms and arterial stenosis, occlusion, thrombosis or dissection [ 8 , 10 ]. Whilst studies have reaffirmed the advantages of PEVAR over open surgical access with regard to immediate- and short-term complications [ 12 ], there exists very little data on the long-term outcomes of PEVAR groin access.…”

Perioperative Outcomes From the Prospective Multicenter Least Invasive Fast-Track EVAR (LIFE) Registry

“…PEVAR is associated with shorter procedure times, lower complication rates, and similar technical success rates compared with surgical cutdown. 10 Avoidance of general anesthesia is feasible in most patients 11 and is associated with lower ICU admission rates and shorter hospitalization. 12,13 Therefore, it is plausible that an EVAR protocol that integrates multiple fast-track elements may act synergistically to accelerate patient recovery, reduce perioperative morbidity, and control healthcare costs compared with standard EVAR.…”