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Percutaneous closure of femoral artery access sites in endovascular stent-graft treatment of aortic disease

Authors
 Chi Young Shim  ;  Sungha Park  ;  Young-Guk Ko  ;  Donghoon Choi  ;  Yangsoo Jang  ;  Won-Heum Shim 
Citation
 INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol.130(2) : 251-254, 2008 
Journal Title
 INTERNATIONAL JOURNAL OF CARDIOLOGY 
ISSN
 0167-5273 
Issue Date
2008
MeSH
Aortic Aneurysm/pathology ; Aortic Aneurysm/surgery ; Aortic Diseases/pathology ; Aortic Diseases/surgery* ; Blood Vessel Prosthesis Implantation/instrumentation ; Blood Vessel Prosthesis Implantation/methods* ; Female ; Femoral Artery/pathology ; Femoral Artery/surgery* ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Stents* ; Suture Techniques*/instrumentation
Keywords
Percutaneous ; Closure ; Stent-graft
Abstract
BACKGROUND: Endovascular techniques using various stent-graft systems are now available to treat aortic disease. Because stent-grafts need large-bore sheaths, arterial surgical cut-downs for access and closure are required. This study describes and reports the results of a percutaneous technique using multiple Perclose devices (Closer-S, 6 Fr) for large arteriotomy closure. METHODS: Sixty-six patients (50 males; mean age 62.8+/-11.8 years) with endovascular stent-graft treatment (from Feb. 2004 to Jan. 2006) were studied. A total of 92 femoral sites were required for large-bore (larger than 14 Fr) sheaths insertion. Stent-graft devices were introduced through 20 Fr (n=8), 18 Fr (n=29), 16 Fr (n=29) or 14 Fr (n=26) sheaths. After deployment of 2 or 3 Percloses (Closer-S, 6 Fr), arteriotomies were dilated to create an appropriate size for large-bore sheaths insertion. After stent-graft insertion, hemostasis was achieved using multiple Perclose sutures placed prior to arterial dilatation. All femoral sites were followed with physical examination and CT angiography. RESULTS: Percutaneous closures with 2 or 3 Perclose devices were successful in 95.7% (88/92) of femoral sites, without complication of hematoma, infection, pseudoaneurysm, or arterial thromboses. In 4.3% (4/92), arterial complications requiring vascular surgical repair occurred. CONCLUSION: Percutaneous closure technique using 2 or 3 Perclose devices placed prior to arterial dilatation is useful for hemostasis in endovascular stent-graft treatment of aortic disease.
Full Text
http://www.sciencedirect.com/science/article/pii/S016752730701844X
DOI
10.1016/j.ijcard.2007.08.086
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Ko, Young Guk(고영국) ORCID logo https://orcid.org/0000-0001-7748-5788
Park, Sung Ha(박성하) ORCID logo https://orcid.org/0000-0001-5362-478X
Shim, Won Heum(심원흠)
Shim, Chi Young(심지영) ORCID logo https://orcid.org/0000-0002-6136-0136
Jang, Yang Soo(장양수) ORCID logo https://orcid.org/0000-0002-2169-3112
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/107893
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