Repair of integrity of the common femoral artery after endovascular interventions

Abstract

Objective — to determine the possibility of using percutaneous vascular closure devices during endovascular aneurysm repair (EVAR).
Materials and methods. In clinic of National Institute of Surgery and Transplantology named after O.O. Shalimov NAMS of Ukraine we completed 133 EVAR. In 14 patients 21 vascular closure devices «Prostar XL» were used, which allowed to suture the artery defect after using the introducer up to 24 F. All patients were implanted «Endurant-II» bifurcated endoprostheses. The diameter of the delivery system of the main part and the contralateral leg was in all cases 18 F. In patients who had percutaneous stitching on one side, on the opposite side access was carried out through a traditional cross-section over a coupling suture with its subsequent layered stitching. Age of patients aged 61 to 75, all of them were male.
Results. The using of vascular closure devices during EVAR with large diameter introductor can significantly reduce the total time of intervention and blood loss. The effectiveness of using the «Prostar XL» was 81 %, which corresponds to the literature data at the stage of learning curve. There was no complication in the process of percutaneous stitching.
Conclusions. The lack of sectional access to the common femoral artery eliminated the deve-lopment of complications such as neuralgia, paresthesia, seroma, lymphostasis, suppuration of the postoperative wound. In patients who have bilateral stitching, the length of stay in a hospital has been shortened and started work earlier. In the planning stage of the intervention, thorough examination of the anatomy of the femur, iliac arteries and the features of the aneurysm is required with the help of the US and MSCT. When performing a puncture angiographic examination is mandatory.