INTRODUCTION: While endovascular aortic aneurysm repair (EVAR) has significantly reduced the morbidity associated with open surgery, efforts continue to minimise the surgical insult to the patient. We report our experience of percutaneous EVAR. PATIENTS AND METHODS: Since June 2005, 17/20 EVARs (85%) have been attempted percutaneously by deployment of two Perclose) devices into each femoral artery prior to passage of the device sheath. The sutures are left untied until the sheath is removed at the end of the procedure, when haemostasis is obtained. Patients were entered onto a prospectively maintained database and followed up at regular intervals in a dedicated EVAR clinic. RESULTS: Access and subsequent graft deployment was successful in all the 17 cases. The range of defects closed ranged from 12-24 Fr. Five patients (29%) required open groin exploration at the end of the procedure to achieve haemostasis. There was a significantly lower incidence of wound complications in the percutaneous EVAR group (6 vs. 10% open cutdown cases, P < 0.05, Mann-Whitney U test). CONCLUSION: Percutaneous EVAR is both a feasible and safe method of performing endovascular abdominal aortic aneurysm repair, which is associated with a reduction in wound complication rates.
INTRODUCTION: While endovascular aortic aneurysm repair (EVAR) has significantly reduced the morbidity associated with open surgery, efforts continue to minimise the surgical insult to the patient. We report our experience of percutaneous EVAR. PATIENTS AND METHODS: Since June 2005, 17/20 EVARs (85%) have been attempted percutaneously by deployment of two Perclose) devices into each femoral artery prior to passage of the device sheath. The sutures are left untied until the sheath is removed at the end of the procedure, when haemostasis is obtained. Patients were entered onto a prospectively maintained database and followed up at regular intervals in a dedicated EVAR clinic. RESULTS: Access and subsequent graft deployment was successful in all the 17 cases. The range of defects closed ranged from 12-24 Fr. Five patients (29%) required open groin exploration at the end of the procedure to achieve haemostasis. There was a significantly lower incidence of wound complications in the percutaneous EVAR group (6 vs. 10% open cutdown cases, P < 0.05, Mann-Whitney U test). CONCLUSION: Percutaneous EVAR is both a feasible and safe method of performing endovascular abdominal aortic aneurysm repair, which is associated with a reduction in wound complication rates.
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