Abstract:
BACKGROUND:Common femoral artery is still the most frequently used site for vascular access, mostly for peripheral arterial interventions, and its puncture remains a significant source of patient's morbidity. Manual compression (MC) has been the gold standard for hemostasis after femoral catheterization until recently, but only in the last few years, vascular closure devices (VCDs) are replacing MC due to their rapid development. Nowadays, vascular surgeons (VSs) are also becoming familiar with VCDs. The purpose of this study was to investigate FemoSeal® arterial closure system use in terms of safety and efficacy in patients undergoing transfemoral peripheral procedure and evaluate the complication risk factors. METHODS:A retrospective analysis to compare 2 different specialists and technique with systematic implantation of FemoSeal® VCD was performed in a cohort of vascular patients treated by endovascular procedure with femoral artery access site over a 2-year period and sheaths ranged from 6F to 8F. All the patients were on antiplatelet therapy and received heparin during the procedure. The FemoSeal® was deployed in common femoral arteries. All patients were examined for access site complication by VS in both groups 20-24 hrs after VCD deployment and 1 and 6 weeks after the procedure with clinical visit and ultrasound duplex scan. Complications, as minor and major hematomas, pseudoaneurysm formation, vessel occlusion or dissection, and infection were recorded. RESULTS:During the study period, 130 FemoSeal® were deployed in 114 patients, 102 FemoSeal® in VS group, and 28 in interventionalist group. Mean age was 57 ± 24 years. There was no significant difference between the 2 groups in terms of comorbidities. Patient follow-up ranged from 1 to 15 months. All but 3 of the FemoSeal® devices were successfully deployed (all 3 cases in group 2). Mobilization time was 6 ± 4 hrs following interventions, and the discharge time ranged from 6 hrs to 7 days after procedure. Early discharge (within 6 hrs) was obtained in 23% of group 1 and in 0 cases of group 2 (P = 0.008). Delayed discharge was obtained in 74% of group 1 (67 pts) and in 70% of group 2 (18 pts) on postoperative day 1 (P = 0.47). Technical success was achieved in 99% of group 1 and in 93% of group 2 (P = 0.87). There were no perioperative deaths. There were no significant differences in terms of minor bleeding complications (P = 0.21) or infections or transfusion needing (P 0.06) in both groups. FemoSeal®-related complications occurred in 6 patients (1 in group 1 and 5 in group 2; P = 0.0017). All complications occurred following therapeutic intervention with 6F sheath introducer. Complication rate resulted significatively higher in group 2 in terms of pseudoaneurysm development (P < 0.0001) and transfusion needing (P = 0.03) in a subgroup analysis on peripheral arterial disease (Rutherford 3-5). Only chronic limb ischemia was found to be independent predictor of complications due to VCD use. CONCLUSIONS:Our data suggest that when simple guidelines are observed, the device is safe, effective, and easy to deploy and allows for early ambulation and discharge. However, appropriate randomized clinical trials could clarify the correct guideline to minimize the complication rates.
journal_name
Ann Vasc Surgjournal_title
Annals of vascular surgeryauthors
Gabrielli R,Rosati MS,Millarelli M,Dante A,Maiorano M,Musilli A,Chiappa R,Ventura Mdoi
10.1016/j.avsg.2018.02.016subject
Has Abstractpub_date
2018-08-01 00:00:00pages
18-24eissn
0890-5096issn
1615-5947pii
S0890-5096(18)30276-0journal_volume
51pub_type
杂志文章,多中心研究abstract:BACKGROUND:Angiofollicular lymphoid hyperplasia (Castleman's disease) is a rare inflammatory condition. Its cause is unknown and it can be both localized and general. Eighty-six percent of lesions are found in the mediastinum or hilum, and 91% are of the hyaline vascular type. Although Castleman's disease is primarily ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2010.02.015
更新日期:2010-08-01 00:00:00
abstract::In this report we describe catheter-based bailout techniques for when the distal end of the ipsilateral leg of an Excluder endograft has remained undeployed due to a broken deployment string. We attempted to advance a percutaneous transluminal angioplasty (PTA) balloon into an undeployed leg via the brachial artery, b...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2012.06.024
更新日期:2013-08-01 00:00:00
abstract:BACKGROUND:We seek to present our experience with innovative abdominal wall arteriovenous access grafts for patients who have run out of traditional dialysis access options. METHODS:We retrospectively reviewed our cohort of patients who have undergone creation of abdominal wall grafts. In all patients, an iliac artery...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2015.04.087
更新日期:2016-01-01 00:00:00
abstract::Twenty-four patients who underwent surgery for pararenal aortic aneurysms between January 1992 and April 1997 are reviewed. Eighteen patients had primary atherosclerotic aneurysms, three patients had symptomatic infected aneurysms, two patients had an aneurysm proximal to a prior aortic repair, and one patient had a p...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100169900164
更新日期:1998-07-01 00:00:00
abstract::Infected abdominal aortic grafts rank as one of the most severe complications of vascular surgery, with high mortality and morbidity. The incidence of infection after prosthetic aortic reconstruction is 1-3%. Diagnosis of vascular graft infection can be occasionally difficult. Clinical manifestations and assessment of...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2007.03.018
更新日期:2007-09-01 00:00:00
abstract::The duplicated common femoral artery can be safely cannulated for femorofemoral bypass, but we recommend postoperative imaging to identify potential complications. We found no previous reports of duplicated common femoral artery. ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2012.10.037
更新日期:2014-01-01 00:00:00
abstract::Renal transplantation has increased the longevity of patients with uremia. An increasing number undergo aortic reconstruction, which exposes the transplanted kidney to ischemic injury. To evaluate the risk for renal failure, loss of the transplant, and methods of renal protection, we reviewed our experience. Clinical ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1007/BF02000752
更新日期:1996-03-01 00:00:00
abstract::Postoperative neurologic deficit is the most devastating complication after thoracoabdominal aortic aneurysm repair. Our aim was to investigate whether nebivolol has protective effects during ischemia or reperfusion and the most effective mechanism of protection via inhibiting nitric oxide (NO) release with an NO synt...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2007.12.024
更新日期:2008-05-01 00:00:00
abstract:BACKGROUND:It is unclear whether prior endovascular therapy (EVT) adversely affects bypass surgery. The aim of this study is to investigate treatment outcomes between initial bypass (bypass-first) and bypass surgery after EVT (EVT-first). METHODS:We conducted a retrospective analysis of critical limb ischemia patients...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2017.06.045
更新日期:2017-11-01 00:00:00
abstract:BACKGROUND:Blunt thoracic aortic injuries (BTAIs) are rare but life threatening. Most BTAI are caused by high-energy trauma. Among children with blunt trauma, the incidence of BTAI is below 1 percent. The present case deals with covered thoracic aortic rupture of a 15-year-old boy. Emphasizing the value and the difficu...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2015.10.040
更新日期:2016-05-01 00:00:00
abstract:BACKGROUND:Current blunt thoracic aortic injury (BTAI) guidelines recommend early repair of traumatic pseudoaneurysms (PSAs) due to risk for subsequent aortic rupture. Recent analyses indicate that early repair is required only in the setting of high-risk features, while delayed repair is safe and associated with lower...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2016.02.021
更新日期:2016-08-01 00:00:00
abstract::Extrahepatic portal vein aneurysm is a rare clinical entity. The two most common locations for aneurysmal formation are at the confluence of the superior mesenteric vein (SMV) and the splenic vein, and at main portal vein trunk, just above the SMV-splenic vein confluence. In this article, two cases of extrahepatic por...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2011.02.046
更新日期:2011-11-01 00:00:00
abstract:BACKGROUND:Arterial revascularizations can present significant challenges when vessels are disadvantaged and advances in technology present the surgeon with innovative opportunities. A number of studies have used the GORE® Hybrid Vascular Graft (GHVG), and we have been using this device in arterial revascularizations s...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2019.12.002
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:The Vascular Quality of Life Questionnaire (VascuQoL-6) was proposed to evaluate specific quality of life of peripheral artery disease (PAD) patients. However, there is no Brazilian-Portuguese version available, blunting its use in Brazilian patients. The objective of the study was to analyze the psychometri...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2018.02.026
更新日期:2018-08-01 00:00:00
abstract::Venous thoracic outlet syndrome (V-TOS) and associated subclavian vein thrombosis (SVT) result in significant patient morbidity and can be difficult to manage. Previous studies have suggested that both mechanical compressive factors and pathological alterations in patient coagulation may contribute to the development ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-006-9106-z
更新日期:2006-09-01 00:00:00
abstract::Carotid artery angioplasty and stenting is gaining popularity, yet the natural history and optimal treatment for recurrent stenoses within stents are not known. Recurrent stenosis rates are not well characterized, with rates between 0 and 33% reported within the first year. Treatment of these lesions with repeat angio...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-001-0279-1
更新日期:2002-09-01 00:00:00
abstract:BACKGROUND:Comorbid conditions are known to increase cardiovascular risk in patients with peripheral artery disease (PAD). However, whether comorbid conditions affect walking capacity remains controversial. Previous studies have analyzed comorbidities separately, but they are known to occur in a clustered fashion in PA...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2013.01.020
更新日期:2014-02-01 00:00:00
abstract:BACKGROUND:Endovascular repair is associated with better 30-day outcomes than open surgical repair for patients with infrarenal aortic aneurysms. In patients with complex aortic aneurysms (CAAs) requiring suprarenal or supravisceral aortic cross-clamping during open repair, few data exist directly comparing the real-wo...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.avsg.2012.05.022
更新日期:2013-04-01 00:00:00
abstract::Thrombotic complications associated with coronavirus disease 2019 (COVID-19) have been described; these have mainly included venous thromboembolic events. Limited literature is available regarding arterial thrombosis. Acute limb ischemia is associated with severe complications that can result in significant morbidity ...
journal_title:Annals of vascular surgery
pub_type:
doi:10.1016/j.avsg.2020.08.115
更新日期:2021-01-01 00:00:00
abstract::This study reports the late results of eight palmar bypass procedures performed between 1983 and 1988 in eight men patients with a mean age of 43 years old, who presented with unilateral digital trophic disorders. The origin of the arterial lesions was post-traumatic in four cases, embolic in three cases, and aneurysm...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02006996
更新日期:1992-09-01 00:00:00
abstract::Resection of carotid body tumors (neck paragangliomas) carries inherent risks of injury to the cranial nerves and other structures as well excessive blood loss. Preoperative embolization has been used to lessen the morbidity in tumors that are larger than 2 cm in diameter. Two female patients presented for treatment w...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100160010058
更新日期:2001-03-01 00:00:00
abstract::Between October 1990 and June 2001, 121 patients underwent surgery for thoracoabdominal aortic aneurysm (TAAA)-99 procedures were elective and 22 were for ruptured aneurysms. Between October 1990 and September 1997, the clamp-and-go technique was used for all aneurysms (43 patients), and from October 1997, clamp-and-g...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-001-0181-x
更新日期:2002-09-01 00:00:00
abstract:BACKGROUND:Venous valvular reflux is the main cause of chronic venous dysfunction. However, the etiology of valvular reflux is not completely understood. We conducted this study to investigate new risk factors for venous reflux of the great saphenous vein (GSV) in the thigh. METHODS:We studied 139 consecutive patients...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2017.05.004
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND:There are two principally different methods for measuring toe pressures (TP)-photoplethysmography (PPG) and laser Doppler (LD). PPG is based on detecting changes in the blood filling of the digital arteries and arterioles, and the LD perfusion signal is derived from the Doppler shift undergone by the emitted...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2011.10.011
更新日期:2012-04-01 00:00:00
abstract::From February 1985 through November 1988, we performed 159 transluminal angioplasty in 135 patients with arterial occlusive disease of the lower limb. The indications were claudication, 114 cases (72%) and limb salvage, 45 cases (28%). Lesions consisted of one or more critical stenoses in 142 cases (61 iliac, 69 femor...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/S0890-5096(06)60832-7
更新日期:1990-11-01 00:00:00
abstract::Elective repair of abdominal aortic aneurysms (AAA) in the elderly has conventionally been associated with higher mortality rates than in younger patients, although some authors do not agree with this view. The aim of this study is to look into current results of surgical treatment in elderly patients with nonruptured...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1007/s100160010082
更新日期:2001-05-01 00:00:00
abstract::To ascertain the histologic relationship between flow surface microostia and perigraft vessels in the healing of a porous vascular prosthesis, a series of careful histologic examinations were carried out on a preclotted, knitted Dacron graft, 8 mm in diameter and 7 cm long, after implantation in the canine infrarenal ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02002335
更新日期:1996-01-01 00:00:00
abstract:BACKGROUND:To assess the peripheral blood flow of patients with peripheral arterial disease (PAD) by indocyanine green (ICG) arteriography (ICGA) with intraarterial injection of ICG and evaluate the efficacy of the ICGA tests. METHODS:This study was undertaken from a retrospective review of patients with PAD who under...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2013.12.036
更新日期:2014-07-01 00:00:00
abstract::The need for enhanced surgical exposure for the high extracranial (Zone III) internal carotid artery is not uncommon. In certain circumstances, the posterior border and angle of the mandible may interfere with access to the distal internal carotid artery (ICA). The use of modified mandibular osteotomies has provided v...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02007006
更新日期:1992-09-01 00:00:00
abstract::We present endovascular treatment of abdominal aortic aneurysm in a 26-year-old man with a 10-year follow-up. A young patient presenting with an abdominal aortic aneurysm is extremely rare, and data describing this population are limited. Open aneurysm repair (OAR) is the treatment of choice in these patients. However...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2015.01.025
更新日期:2015-07-01 00:00:00