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The Preclose Technique in Percutaneous Endovascular Aortic Repair: A Systematic Literature Review and Meta-analysis

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Abstract

Purpose

To establish the efficacy and safety of the preclose technique in total percutaneous endovascular aortic repair (PEVAR).

Methods

A systematic literature search of Medline database was conducted for series on PEVAR published between January 1999 and January 2012.

Results

Thirty-six articles comprising 2,257 patients and 3,606 arterial accesses were included. Anatomical criteria used to exclude patients from undergoing PEVAR were not uniform across all series. The technical success rate was 94 % per arterial access. Failure was unilateral in the majority (93 %) of the 133 failed PEVAR cases. The groin complication rate in PEVAR was 3.6 %; a minority (1.6 %) of these groin complications required open surgery. The groin complication rate in failed PEVAR cases converted to groin cutdown was 6.1 %. A significantly higher technical success rate was achieved when arterial access was performed via ultrasound guidance. Technical failure rate was significantly higher with larger sheath size (≥20F).

Conclusion

The preclose technique in PEVAR has a high technical success rate and a low groin complication rate. Technical success tends to increase with ultrasound-guided arterial access and decrease with larger access. When failure occurs, it is unilateral in the majority of cases, and conversion to surgical cutdown does not appear to increase the operative risk.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Division of Interventional Radiology and Image-Guided Medicine, Department of Radiology, Emory University School of Medicine, 1364 Clifton Road NE, Atlanta, GA, 30322, USA

    Abdel Aziz A. Jaffan

  2. Section of Vascular and Interventional Radiology, Department of Diagnostic Imaging, The Warren Alpert Medical School of Brown University, Rhode Island Hospital, 593 Eddy Street, Providence, RI, 02903, USA

    Ethan A. Prince & Timothy P. Murphy

  3. Mercy Hospital, 4300 W Memorial Road, Oklahoma City, OK, 73120, USA

    Christopher O. Hampson

Authors
  1. Abdel Aziz A. Jaffan
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  2. Ethan A. Prince
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  3. Christopher O. Hampson
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  4. Timothy P. Murphy
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Correspondence to Abdel Aziz A. Jaffan.

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Jaffan, A.A.A., Prince, E.A., Hampson, C.O. et al. The Preclose Technique in Percutaneous Endovascular Aortic Repair: A Systematic Literature Review and Meta-analysis. Cardiovasc Intervent Radiol 36, 567–577 (2013). https://doi.org/10.1007/s00270-013-0593-3

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