Subscribe to RSS
DOI: 10.1055/s-0035-1556826
Current Status of Percutaneous Endografting
Publication History
Publication Date:
18 August 2015 (online)
![](https://www.thieme-connect.de/media/sir/201503/lookinside/thumbnails/10-1055-s-0035-1556826_00907-1.jpg)
Abstract
Totally percutaneous endovascular abdominal aortic aneurysm repair (PEVAR) using suture-mediated closure devices (SMCDs) has several well-established advantages over standard open femoral exposure as a direct consequence of being less invasive and having shorter times to hemostasis and procedure completion. The first multicenter randomized controlled trial designed to assess the safety and efficacy of PEVAR and to compare percutaneous access with standard open femoral exposure was recently published (the PEVAR trial). The PEVAR trial demonstrated that percutaneous endografting is safe, effective, and noninferior to standard open femoral exposure among trained operators. The study reaffirmed the results of several recent single center and nonrandomized studies, demonstrating that percutaneous access facilitated shorter procedures, shorter times to secure hemostasis, and improved quality of life for patients. As PEVAR has gained popularity among patients and physicians, refinements to the technique and patient selection process have been made. There has been growing interest in treating patients with anatomical characteristics previously thought to be unsuitable for PEVAR, such as common femoral artery (CFA) calcifications, scarred groins, small CFA diameter, and high patient body mass index (BMI). However, observance of strict procedural technique and consideration for patient selection criteria remain paramount in achieving acceptable technical success rates with PEVAR.
-
References
- 1 Nelson PR, Kracjer Z, Kansal N , et al. A multicenter, randomized, controlled trial of totally percutaneous access versus open femoral exposure for endovascular aortic aneurysm repair (the PEVAR trial). J Vasc Surg 2014; 59 (5) 1181-1193
- 2 Haas PC, Krajcer Z, Diethrich EB. Closure of large percutaneous access sites using the Prostar XL Percutaneous Vascular Surgery device. J Endovasc Surg 1999; 6 (2) 168-170
- 3 Dosluoglu HH, Cherr GS, Harris LM, Dryjski ML. Total percutaneous endovascular repair of abdominal aortic aneurysms using Perclose ProGlide closure devices. J Endovasc Ther 2007; 14 (2) 184-188
- 4 Torsello GB, Kasprzak B, Klenk E, Tessarek J, Osada N, Torsello GF. Endovascular suture versus cutdown for endovascular aneurysm repair: a prospective randomized pilot study. J Vasc Surg 2003; 38 (1) 78-82
- 5 Arslan B, Turba UC, Sabri S, Angle JF, Matsumoto AH. Current status of percutaneous endografting. Semin Intervent Radiol 2009; 26 (1) 67-73
- 6 Malkawi AH, Hinchliffe RJ, Holt PJ, Loftus IM, Thompson MM. Percutaneous access for endovascular aneurysm repair: a systematic review. Eur J Vasc Endovasc Surg 2010; 39 (6) 676-682
- 7 Eisenack M, Umscheid T, Tessarek J, Torsello GF, Torsello GB. Percutaneous endovascular aortic aneurysm repair: a prospective evaluation of safety, efficiency, and risk factors. J Endovasc Ther 2009; 16 (6) 708-713
- 8 Georgiadis GS, Antoniou GA, Papaioakim M , et al. A meta-analysis of outcome after percutaneous endovascular aortic aneurysm repair using different size sheaths or endograft delivery systems. J Endovasc Ther 2011; 18 (4) 445-459
- 9 Etezadi V, Katzen BT, Naiem A , et al. Percutaneous suture-mediated closure versus surgical arteriotomy in endovascular aortic aneurysm repair. J Vasc Interv Radiol 2011; 22 (2) 142-147
- 10 Mousa AY, Campbell JE, Broce M , et al. Predictors of percutaneous access failure requiring open femoral surgical conversion during endovascular aortic aneurysm repair. J Vasc Surg 2013; 58 (5) 1213-1219
- 11 Bechara CF, Barshes NR, Pisimisis G , et al. Predicting the learning curve and failures of total percutaneous endovascular aortic aneurysm repair. J Vasc Surg 2013; 57 (1) 72-76
- 12 Bensley RP, Hurks R, Huang Z , et al. Ultrasound-guided percutaneous endovascular aneurysm repair success is predicted by access vessel diameter. J Vasc Surg 2012; 55 (6) 1554-1561
- 13 Sarmiento JM, Wisniewski PJ, Do NT , et al. The Kaiser Permanente experience with ultrasound-guided percutaneous endovascular abdominal aortic aneurysm repair. Ann Vasc Surg 2012; 26 (7) 906-912
- 14 Smith ST, Timaran CH, Valentine RJ, Rosero EB, Clagett GP, Arko FR. Percutaneous access for endovascular abdominal aortic aneurysm repair: can selection criteria be expanded?. Ann Vasc Surg 2009; 23 (5) 621-626
- 15 Al-Khatib WK, Zayed MA, Harris EJ, Dalman RL, Lee JT. Selective use of percutaneous endovascular aneurysm repair in women leads to fewer groin complications. Ann Vasc Surg 2012; 26 (4) 476-482
- 16 Minion DJ, Davenport DL. Access techniques for EVAR: percutaneous techniques and working with small arteries. Semin Vasc Surg 2012; 25 (4) 208-216