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Fascia suturing of large access sites after endovascular treatment of aortic aneurysms and dissections
Örebro University, Department of Clinical Medicine.
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2006 (English)In: Journal of Endovascular Therapy, ISSN 1526-6028, E-ISSN 1545-1550, Vol. 13, no 2, p. 152-157Article in journal (Refereed) Published
Abstract [en]

PURPOSE: To evaluate a technique for closure of a femoral artery access in which the cribriform fascia covering the common femoral artery is sutured.

METHODS: A consecutive series of 127 patients (103 men; median age 74 years, range 45- 89) underwent endovascular aortic aneurysm repair between August 2001 and September 2004. Twelve patients underwent a secondary intervention for a total of 139 procedures in the group. Sixty-one (43.9%) of the 139 operations were acute. Among the 257 femoral arteries used for access, a fascia suturing technique was performed in 131 (51.0%). Data were collected for analysis of access site complications, bleeding, thrombosis, pseudoaneurysm, and stenosis. A subgroup of 72 patients had ankle-brachial indexes (ABI) recorded; another subgroup of 50 patients were also investigated by duplex ultrasonography.

RESULTS: Complications occurred in 18 (13.7%) of the 131 sutured cases. The majority (n = 16) arose within 24 hours: 8 cases of perioperative bleeding or thrombosis required open surgery and 8 cases were reoperated within 24 hours for bleeding (n = 4), thrombosis (n = 3), and 1 intimal dissection. The acute failure rate was 12.2%. Two patients had late complications: 1 case of neuralgia and 1 pseudoaneurysm that required acute surgery 28 months postoperatively. The ABI did not change significantly from pre- to postoperatively in the 72 patients examined. Five patients with stenoses did not have a reduction in ABI. In the 66 sites examined with ultrasound in 50 patients, 3 minor pseudoaneurysms were detected.

CONCLUSION: The fascia suturing technique for closure of a femoral artery access during endovascular repair of aortic diseases is feasible, even in acute situations. Failures can be managed easily. Late complications requiring additional procedures are rare.

Place, publisher, year, edition, pages
2006. Vol. 13, no 2, p. 152-157
National Category
Surgery
Research subject
Surgery
Identifiers
URN: urn:nbn:se:oru:diva-26547DOI: 10.1583/05-1719R.1PubMedID: 16643069OAI: oai:DiVA.org:oru-26547DiVA, id: diva2:573072
Available from: 2012-11-29 Created: 2012-11-29 Last updated: 2017-12-07Bibliographically approved
In thesis
1. Aspects of endovascular treatment of abdominal aortic aneurysms
Open this publication in new window or tab >>Aspects of endovascular treatment of abdominal aortic aneurysms
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Place, publisher, year, edition, pages
Örebro: Örebro universitet, 2012. p. 73
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 77
National Category
Surgery
Research subject
Surgery
Identifiers
urn:nbn:se:oru:diva-25868 (URN)978-91-7668-904-2 (ISBN)
Public defence
2012-11-30, Wilandersalen, Universitetssjukhuset (USÖ), Örebro, 13:00 (Swedish)
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Supervisors
Available from: 2012-09-17 Created: 2012-09-17 Last updated: 2017-10-17Bibliographically approved

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Larzon, Thomas

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