Abstract
Background: Total percutaneous closure for the site of femoral arterial puncture using Perclose ProGlide (PP) has become prevalent post-percutaneous endovascular aortic repair (EVAR) and veno-arterial extracorporeal membrane oxygenation (VA-ECMO).Objective: To evaluate the safety and efficacy of total percutaneous closure of the femoral artery access site post-EVAR compared with VA-ECMO.Methods: This was a retrospective observational study conducted over 4 years, including 88 patients who underwent EVAR (64 patients) and VA-ECMO (24 patients). Perclose ProGlide devices were used in the femoral artery puncture sites closed percutaneously. In this study, technical success was defined as successful arterial closure of the common femoral artery (CFA) without additional surgical or endovascular procedures to prevent vessel leaking. Access site complications, including overt bleeding requiring transfusion or surgical intervention, minor bleeding, tinea cruris, pseudoaneurysm, and lymphocele, were recorded 24 h and 30 days after arterial closure.Results: Each group's technical success rates were 95.8% (VA-ECMO) and 92.2% EVAR, respectively. There were no differences in the periprocedural complications of major bleeding, pseudoaneurysm, minor bleeding, acute limb ischemia, and groin infection. Furthermore, we did not observe any complications such as arterial thrombosis, dissection, stenosis, arteriovenous fistula, hematoma, groin infection, or lymphocele at the access site by following-up an ultrasound examination. There was no significant difference in the technical success rate of percutaneous closure by the PP device in the EVAR and VA-ECMO oxygenation groups. Also, no periprocedural or 30-day complications were observed at the access site of the EVAR and VA-ECMO patients.
Highlights
Recent studies revealed that Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) as a kind of mechanical circulatory and gas exchange support could benefit patients with shock or without return of spontaneous circulation during cardiorespiratory resuscitation [1,2,3]
There was no significant difference between the two groups regarding body mass index (BMI), diabetes mellitus, and coronary artery disease (CAD)
We revealed that the incidence of Perclose ProGlide (PP) closure device-related complications and the device technique success rate were similar in endovascular aortic repair (EVAR) and VA-ECMO patients
Summary
Recent studies revealed that Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) as a kind of mechanical circulatory and gas exchange support could benefit patients with shock or without return of spontaneous circulation during cardiorespiratory resuscitation [1,2,3]. The most frequently accessed site for VA-ECMO is through the common femoral artery (CFA), using either open or percutaneous techniques. Percutaneous closure devices for a femoral arterial access site have been approved for use with up to only 10 French (Fr) sheaths in the past decades [9, 10]. Total percutaneous closure for the site of femoral arterial puncture using Perclose ProGlide (PP) has become prevalent post-percutaneous endovascular aortic repair (EVAR) and veno-arterial extracorporeal membrane oxygenation (VA-ECMO)
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