Optimizing Femoral Access in Emergency EVAR with a Decision-Making Algorithm

被引:0
|
作者
Mirabella, Domenico [1 ]
Bruno, Salvatore [1 ]
La Marca, Manfredi Agostino [1 ]
Dinoto, Ettore [1 ]
Rodriquenz, Edoardo [1 ]
Micciche, Andrea [1 ]
Pecoraro, Felice [1 ,2 ]
机构
[1] AOUP Policlin P Giaccone, Vasc Surg Unit, I-90127 Palermo, Italy
[2] Univ Palermo, Dept Surg Oncol & Oral Sci, I-90133 Palermo, Italy
来源
LIFE-BASEL | 2024年 / 14卷 / 09期
关键词
femoral access; percutaneous access; rAAA; EVAR; surgical conversion; ENDOVASCULAR ANEURYSM REPAIR; PERCUTANEOUS ACCESS; DIFFICULT ACCESS; CLOSURE DEVICES; CUTDOWN ACCESS; PUNCTURE; OUTCOMES; ARTERY;
D O I
10.3390/life14091113
中图分类号
Q [生物科学];
学科分类号
07 ; 0710 ; 09 ;
摘要
Endovascular aneurysm repair (EVAR) has become the preferred approach over open repair for abdominal aortic aneurysms (AAAs) due to its minimally invasive nature. The common femoral artery (CFA) is the main access vessel for EVAR, with both surgical exposure and percutaneous access being utilized. However, in emergent cases, percutaneous access can be challenging and may result in complications such as bleeding or dissection thrombosis, leading to the need for surgical conversion. This study aimed to share experiences in implementing a decision-making algorithm to reduce surgical conversions due to percutaneous access failures. A total of 74 aortic patients treated with EVAR in emergency settings were included in this retrospective study. This study focused on various outcomes such as perioperative mortality, morbidity, procedure time, surgical exposure time, and surgical conversion rate. After the implementation of the decision-making algorithm, decreases in surgical conversions and operating time were observed. Percutaneous access was found to be more challenging in cases with specific anatomical characteristics of the CFA, such as severe atherosclerosis or smaller vessel diameter. This study highlighted the importance of carefully assessing patient anatomical features and utilizing a decision-making algorithm to optimize outcomes in EVAR procedures. Further research is needed to continue improving practices for managing aortic aneurysms and reducing complications in femoral artery access approaches.
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页数:12
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