Vascular colsure device failure and complication during EVAR or TEVAR: Frequency and Rick Factors

초록

Pu4lose Vascular closure devices (VCDs) are effective in reducing the time to ambulation for patients undergoing endovascular treatrnent in reducing the risk of vascular complications in selected patient cohorts. However, the ftequency and consecluence of failure of VCDs is not wdl defined. So that we evaluated complications and identification of potenrial risk factors that could predict major or minor complications using VCDs during EVAR or TEVAR. Method: Respectively, we reviewed 192 access sites of III patients that used with VCDs during FVAR or TEVAR form January 2013 to July 2019. VCD failure was defined as unsuccessful deployment or failure to achieve hemostasis. Major vascular compLication was defined as any retroperitoneal hemorrhage, Iimb ischemia, or any surgical repair. Minor vascular complication was defined as any groin bleeding, hematoma ()5 cm) or pseudoaneurysm without major complication. Result Among the 192 VCDs use in the srudy, VCD failed in 42 limbs (21.890). There were Il (7.87o) major complications (2 renoperitoneal hematomas, 9 Iimbs occlusions or 3 open conversions due to acrive bleeding) and 20 (I0.4%) minor complicarions (4 groin bleedings, 14 hematomas or 2 pseudoaneurysms). The common femoral artery(CFA) calcificarion over 50/o(p<0.001), subcutaneous tissue within lcm(p=0.002), iliac tortuosrty ( 3 iliac artery at one axial CT image)(p=0.003 and VCDs failure(p<0.00l), were significantly increased in complication goups. Conclusion: In contemporary practice, VCD failure isn t rare, but when it does fail or there are severe calcificarion CFA with thin soft tissue or torruos fiac artery, it is associated with a significant increase in the risk of vascular complications. Patients with VCD failure should be closdy monitored.