Use of a Steerable Sheath for Completely Femoral Access in Branched Endovascular Aortic Repair Compared to Upper Extremity Access.

Autor: Hauck SR; Cardiovascular and Interventional Radiology, Department of Bioimaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria., Eilenberg W; Division of Vascular Surgery, Department of General Surgery, Medical University of Vienna, Vienna, Austria., Kupferthaler A; Cardiovascular and Interventional Radiology, Department of Bioimaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria.; Department of Diagnostic and Interventional Radiology, Ordensklinikum Linz, Linz, Austria.; Johannes Kepler University Linz, Medical Faculty, Linz, Austria., Kern M; Department of Radiology, Klinik Floridsdorf, Vienna, Austria., Dachs TM; Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria., Wressnegger A; Cardiovascular and Interventional Radiology, Department of Bioimaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria., Neumayer C; Division of Vascular Surgery, Department of General Surgery, Medical University of Vienna, Vienna, Austria., Loewe C; Cardiovascular and Interventional Radiology, Department of Bioimaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria., Funovics MA; Cardiovascular and Interventional Radiology, Department of Bioimaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria. martin.funovics@meduniwien.ac.at.
Jazyk: angličtina
Zdroj: Cardiovascular and interventional radiology [Cardiovasc Intervent Radiol] 2022 Jun; Vol. 45 (6), pp. 744-751. Date of Electronic Publication: 2022 Apr 07.
DOI: 10.1007/s00270-022-03064-8
Abstrakt: Purpose: To compare bridging stent graft (BSG) implantation in downward oriented branches in branched endovascular aortic repair (bEVAR), using a commercially available steerable sheath from an exclusively femoral access (TFA) with traditional upper extremity access (UEA).
Methods: In a retrospective cohort study, 7 patients with 19 branches in the TFA cohort received BSG insertion using the Medtronic Heli FX steerable sheath from a femoral access, and 10 patients with 32 branches in the UEA cohort from a brachial approach. Technical success, total intervention time, fluoroscopy time, branch cannulation time, and complication rate were recorded.
Results: Technical success was 19/19 branches in the TFA and 31/32 in the UEA cohort. The mean branch cannulation time was considerably shorter in the TFA group (17 vs. 29 min, p = 0.003), and total intervention time tended to be shorter (169 vs. 217 min, p = 0.176).
Conclusion: Using a commercially available steerable sheath allowed successful cannulation of all branches in this cohort and was associated with significantly shorter branch cannulation times. Potentially, this technique can lower the stroke and brachial puncture site complication risk as well as reduce total intervention time and radiation dose.
Level of Evidence: 2b, retrospective cohort study.
(© 2022. The Author(s).)
Databáze: MEDLINE
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