Total percutaneous access for endovascular aortic aneurysm repair (“Preclose” technique)

Abstract

Percutaneous access for endovascular aortic repair is safe and feasible using the Proglide device. Although the success rates are higher for smaller size sheaths, successful closures may be obtained for up to 24F sheaths. Percutaneous access may result in shorter overall procedure times and potentially lower operating room costs, but this appears to be offset by the cost of the closure devices.

Implante por cateter de bioprótese valvar para tratamento da estenose aórtica: experiência de três anos

“…In our initial experience, we detected an elevated incidence of vascular and hemorrhagic complications in the vascular access site, attributed to the learning curve and to the lack of familiarity in handling the Prostar hemostastic device. That fact determined a change in the hemostasis technique, with the use of two or three Proglide devices (Perclose), following the experience with the percutaneous implantation of endoprostheses for correcting aortic aneurysm, with sheaths of up to 24F 22 . After this change in technique, hemorrhagic and vascular complications became less frequent.…”

Kilt Technique as an Angle Modification Method for Endovascular Repair of Abdominal Aortic Aneurysm with Severe Neck Angle

“…Bilateral common femoral arteries were prepared with the closure devices using the pre-close technique 5) and bilateral access was obtained with large sheaths (9 Fr to 12 Fr sheaths were used initially). After the access procedure was finished, intra-arterial or intra-venous heparinization was performed for a target-activated clotting time of over 300 seconds.…”

Risk factors for femoral arterial complications and management

“…The continued development of percutaneous aortic valve interventions, as well as expanding abdominal and thoracic aortic stent graft use, has led to increasing interest in percutaneous large-hole closure. Perclose, using two 6-F devices for "preclosure, " and Prostar XL are particularly well positioned in this respect, and there are some excellent descriptive series showing a high success rate, despite use of sheaths up to 24 F. 7 There is increasing interest in closure of antegrade femoral punctures, and a number of studies have described use of many of the previously mentioned devices, albeit offlabel. [8][9][10] Similarly, there is additional interest in using VCDs off-label for the brachial approach, although the limited depth of the arteriotomy should exclude a number of devices from consideration.…”