Femoral artery calcification as a determinant of success for percutaneous access for endovascular abdominal aortic aneurysm repair
| Autor: | Audra A. Duncan, Gustavo S. Oderich, Thomas C. Bower, Jesse Manunga, Manju Kalra, Mark D. Fleming, Peter Gloviczki |
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| Rok vydání: | 2013 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Percutaneous medicine.medical_treatment Punctures Femoral artery Postoperative Hemorrhage Aortography Severity of Illness Index Endovascular aneurysm repair Aortic aneurysm Risk Factors medicine.artery medicine Humans Blood Transfusion Vascular closure device Vascular Calcification Aged Retrospective Studies Aged 80 and over Chi-Square Distribution Groin Hemostatic Techniques business.industry Endovascular Procedures Equipment Design Perioperative Middle Aged medicine.disease Abdominal aortic aneurysm Surgery Femoral Artery Treatment Outcome medicine.anatomical_structure Female Radiology Tomography X-Ray Computed Cardiology and Cardiovascular Medicine business Aortic Aneurysm Abdominal |
| Zdroj: | Journal of Vascular Surgery. 58:1208-1212 |
| ISSN: | 0741-5214 |
| Popis: | ObjectiveThis study was conducted to determine the outcomes and predictive factors for success during percutaneous endovascular aneurysm repair (PEVAR) using vascular closure devices (VCDs).MethodsThe clinical data of patients who underwent PEVAR between 2005 and 2012 were retrospectively reviewed. Patient demographics, body mass index, sheath size, device types, diameter of femoral arteries, and extent and location of femoral artery calcification were recorded. Included were all consecutive patients treated by PEVAR with sheath sizes ranging from 12F to 24F. End points were technical success, conversion to open femoral artery repair, and complications.ResultsDuring this period, 752 patients were treated by EVAR. Of these, 391 femoral arteries in 222 patients (29.5%; 197 men, 25 women), with a mean age of 74.8 years (range, 51-93.7 years), underwent PEVAR (169 bilateral and 53 unilateral percutaneous access). Patients with >50% anterior femoral artery calcifications or those with previous femoral artery reconstructions were not offered PEVAR. Technical success of PEVAR was 96.4% (377 of 391), with an average of two VCDs used per groin. Fourteen intraoperative failures were managed with open femoral conversion using primary repair (five) or patch angioplasty (nine). In nine patients, the procedure was converted from local to general anesthesia. Four patients required a perioperative blood transfusion. There were no significant differences in body mass index (P = .26), femoral artery size preprocedure (P = .33) or postprocedure (P = .37), sheath size (≥20F vs ≤18F), or type of VCD used between the success and failure groups. Pairwise comparisons revealed increased failure rate (P < .001) between patients with 50% posterior calcification. There was no significant difference (P = .53) between patients with |
| Databáze: | OpenAIRE |
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