Percutaneous endovascular aortic repair using the preclose technique: complications and treatments

Objective To evaluate the safety and efficacy of the ProGlide closure system after percutaneous placement of aortic endografts.Methods From December 2012 to May 2013,clinical data of 116 cases with endovascular stent-graft therapy and percutaneous closure technique were analyzed retrospectively.Results The technical success rate of endovascular therapy was 99.1％ (115/116).Hemostasis was achieved using multiple ProGlide device in a total of 150 femoral sites required for large-bore sheaths insertion,including 20-25 F access sites (n =99) and ＜ 18 F access sites (n =51).In 7 patients,ProGlide devices failed to achieve hemostasis,leading to ongoing bleeding requiring prolonged additional compression (n =4) and surgical repair (n =3).In 6 patients,ProGlide devices caused the stenosis or occlusion in the puncture site as a result of the suture pursing the artery too tightly (n =l) and local dissection (n =5),which were treated with surgical repair.The initial technical success rate for the ProGlide closure devices was 85.3％ (128/150),and the secondary technical success rate was 91.3％(137/150).Blue toe syndrome was observed in 7.3％ (11/150).There was no perioperative mortality and the mean postoperative in-hospital stay was 4.3 ± 1.7 days.Conclusions Percutaneous closure technique using multiple Perclose ProGlide devices is safe and effective in endovascular stent-graft treatment of aortic disease. Key words: Postoperative complications; Aortic aneurysm;  Aneurysm, dissecting; Percutaneous closure;  Endovascular repair