Semin intervent Radiol 2009; 26(1): 067-073
DOI: 10.1055/s-0029-1208387
© Thieme Medical Publishers

Current Status of Percutaneous Endografting

Bulent Arslan1 , Ulku C. Turba1 , Saher Sabri1 , J. Fritz Angle1 , Alan H. Matsumoto1
  • 1Division of Interventional Radiology, University of Virginia Health System, Charlottesville, Virginia
Further Information

Publication History

Publication Date:
16 March 2009 (online)

ABSTRACT

Significant advances in the technology and techniques in the field of endovascular thoracic and abdominal aortic aneurysm repair have been made since its introduction in the early 1990s. The low incidence of periprocedural complications combined with comparable early outcomes to open surgery have made the endovascular treatment option the first choice of therapy in patients whose aortic anatomy is suitable for endografting. All currently available endografts for aortic aneurysm repair have delivery systems at least 21-French in outer diameter and have traditionally been inserted via surgical cutdowns. More recently, attempts to validate a totally percutaneous approach to the placement of these devices have been introduced by utilizing suture-mediated closure devices. This article will provide an overview of suture-mediated closure devices, our experience with the off-label application of suture-mediated devices for percutaneous closure of arterial access sites during endovascular aneurysm repair, and a review of the literature on this topic.

REFERENCES

  • 1 Parodi J C, Palmaz J C, Barone H D. Transfemoral intraluminal graft implantation for abdominal aortic aneurysms.  Ann Vasc Surg. 1991;  5 491-499
  • 2 Haas P C, Kracjer Z, Dietrich E B. Closure of large percutaneous access sites using the Prostar XL percutaneous vascular surgery device.  J Endovasc Surg. 1999;  6 168-170
  • 3 Lee W A, Brown M P, Nelson P R, Huber T S. Total percutaneous access for endovascular aortic aneurysm repair (“Preclose” technique).  J Vasc Surg. 2007;  45 1095-1101
  • 4 Najjar S F, Mueller K H, Ujiki M B, Morasch M D, Matsumura J S, Eskandari M K. Percutaneous endovascular repair of ruptured abdominal aortic aneurysms.  Arch Surg. 2007;  142 1049-1052
  • 5 Kaufman J A, Song H K, Ham B B, Slater M S. Traumatic thoracic aortic transection in small-diameter aortas: percutaneous endograft repair.  J Vasc Interv Radiol. 2007;  18 1429-1433
  • 6 Traul D K, Clair D G, Gray B, O'Hara P J, Ouriel K. Percutaneous endovascular repair of infrarenal abdominal aortic aneurysms: a feasibility study.  J Vasc Surg. 2000;  32 770-776
  • 7 Teh L G, Sieunnarine K, van Schie G et al.. Use of the percutaneous vascular surgery device for closure of femoral access sites during endovascular aneurysm repair: lessons from our experience.  Eur J Vasc Endovasc Surg. 2001;  22 418-423
  • 8 Howell M, Villareal R, Krajcer Z. Percutaneous access and closure of femoral artery access sites associated with endoluminal repair of abdominal aortic aneurysms.  J Endovasc Ther. 2001;  8 68-74
  • 9 Kennedy P T, Collins A, Blair P H, Ellis P K. Suture mediated vascular closure devices for large arteriotomies.  Br J Surg. 2003;  90 508
  • 10 Torsello G B, Kasprzak B, Klenk E, Tessarek J, Osada N, Torsello G F. Endovascular suture versus cutdown for endovascular aneurysm repair: a prospective randomized pilot study.  J Vasc Surg. 2003;  38 78-82
  • 11 Morasch M D, Kibbe M R, Evans M E et al.. Percutaneous repair of abdominal aortic aneurysm.  J Vasc Surg. 2004;  40 12-16
  • 12 Lee W A, Brown M P, Nelson P R, Huber T S, Seeger J M. Midterm outcomes of femoral arteries after percutaneous endovascular aortic repair using the preclose technique.  J Vasc Surg. 2008;  47 919-923
  • 13 Watelet J, Gallot J C, Thomas P, Douvrin F, Plissonnier D. Percutaneous repair of aortic aneurysms: a prospective study of suture-mediated closure devices.  Eur J Vasc Endovasc Surg. 2006;  32 261-265
  • 14 Jean-Baptiste E, Hassen-Khodja R, Haudebourg P, Bouillanne P J, Declemy S, Batt M. Percutaneous closure devices for endovascular repair of infrarenal abdominal aortic aneurysms: a prospective, non-randomized comparative study.  Eur J Vasc Endovasc Surg. 2008;  35 422-428
  • 15 Arthurs Z M, Starnes B W, Sohn V Y, Singh N, Andersen C A. Ultrasound-guided access improves rate of access related complications for totally percutaneous aortic aneurysm repair.  Ann Vasc Surg. 2008;  22 736-741

Bulent ArslanM.D. 

Assistant Professor of Radiology, Division of Interventional Radiology, University of Virginia Health System

Box 800170, Charlottesville, VA 22947

Email: ba6e@virginia.edu

    >