Predilation technique with balloon angioplasty to facilitate percutaneous groin access of large size sheath through scar tissue

Felice Pecoraro, Felice Pecoraro, Frank J Veith, Mario Lachat, Gilbert Puippe, Johnny Steuer, Mayur Krishnaswamy, Zoran Rancic, Nicola Mangialardi, Neal S Cayne, Thomas Pfammatter

Risultato della ricerca: Article

2 Citazioni (Scopus)

Abstract

Purpose: Percutaneous remote access for endovascular aortic repair is an advantageous alternative to open access. Previous surgery in the femoral region and the presence of synthetic vascular grafts in the femoral/iliac arteries represent major limitations to percutaneous remote access. The aim of this study was to evaluate an original technique used for enabling percutaneous remote access for thoracic or abdominal endovascular aortic repair in patients with scar tissue and/or a vascular graft in the groin. Methods: Twenty-five consecutive patients with a thoracic (11/25; 44%) or an aortic aneurysm (14/25; 66%) and with a synthetic vascular graft in the groin (16/25; 64%) or a redo groin access (9/25; 36%) were managed through the percutaneous remote access. In all patients, a percutaneous transluminal angioplasty balloon was used to predilate the scar tissue and the femoral artery or the synthetic vascular graft after preclosing (ProGlide®; Abbott Vascular, Santa Clara, CA, USA). In 10 patients, requiring a 20 Fr sheath, a 6 mm percutaneous transluminal angioplasty balloon was used; and in the remaining 15, requiring a 24 Fr sheath, an 8 mm percutaneous transluminal angioplasty balloon. Preclosing was exclusively performed using ProGlide®. Mean follow-up was 15 months. Results: In all cases, stent-graft deployment was successful. There was one surgical conversion (4%; 1/25) due to bleeding from a femoral anastomosis. Two cases required additional percutaneous maneuvers (postclosing with another system in one patient and endoluminal shielding with stent-graft in the other patient). No pseudoaneurysm or access complication occurred during the follow-up. Conclusions: Percutaneous access in redo groins with scar tissue and/or synthetic vascular graft using ultrasound-guided punction, preclosing with ProGlide® system and predilation with percutaneous transluminal angioplasty balloon to introduce large size sheath as used for endovascular aortic repair showed to be feasible, safe and with few local complications.
Lingua originaleEnglish
pagine (da-a)396-401
Numero di pagine6
RivistaVascular
Volume25
Stato di pubblicazionePublished - 2017

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Balloon Angioplasty
Groin
Cicatrix
Blood Vessels
Transplants
Angioplasty
Femoral Artery
Thigh
Stents
Thorax
Aortic Aneurysm
Iliac Artery
False Aneurysm
Hemorrhage

All Science Journal Classification (ASJC) codes

  • Surgery
  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cita questo

Pecoraro, F., Pecoraro, F., Veith, F. J., Lachat, M., Puippe, G., Steuer, J., ... Pfammatter, T. (2017). Predilation technique with balloon angioplasty to facilitate percutaneous groin access of large size sheath through scar tissue. Vascular, 25, 396-401.

Predilation technique with balloon angioplasty to facilitate percutaneous groin access of large size sheath through scar tissue. / Pecoraro, Felice; Pecoraro, Felice; Veith, Frank J; Lachat, Mario; Puippe, Gilbert; Steuer, Johnny; Krishnaswamy, Mayur; Rancic, Zoran; Mangialardi, Nicola; Cayne, Neal S; Pfammatter, Thomas.

In: Vascular, Vol. 25, 2017, pag. 396-401.

Risultato della ricerca: Article

Pecoraro, F, Pecoraro, F, Veith, FJ, Lachat, M, Puippe, G, Steuer, J, Krishnaswamy, M, Rancic, Z, Mangialardi, N, Cayne, NS & Pfammatter, T 2017, 'Predilation technique with balloon angioplasty to facilitate percutaneous groin access of large size sheath through scar tissue', Vascular, vol. 25, pagg. 396-401.
Pecoraro, Felice ; Pecoraro, Felice ; Veith, Frank J ; Lachat, Mario ; Puippe, Gilbert ; Steuer, Johnny ; Krishnaswamy, Mayur ; Rancic, Zoran ; Mangialardi, Nicola ; Cayne, Neal S ; Pfammatter, Thomas. / Predilation technique with balloon angioplasty to facilitate percutaneous groin access of large size sheath through scar tissue. In: Vascular. 2017 ; Vol. 25. pagg. 396-401.
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title = "Predilation technique with balloon angioplasty to facilitate percutaneous groin access of large size sheath through scar tissue",
abstract = "Purpose: Percutaneous remote access for endovascular aortic repair is an advantageous alternative to open access. Previous surgery in the femoral region and the presence of synthetic vascular grafts in the femoral/iliac arteries represent major limitations to percutaneous remote access. The aim of this study was to evaluate an original technique used for enabling percutaneous remote access for thoracic or abdominal endovascular aortic repair in patients with scar tissue and/or a vascular graft in the groin. Methods: Twenty-five consecutive patients with a thoracic (11/25; 44{\%}) or an aortic aneurysm (14/25; 66{\%}) and with a synthetic vascular graft in the groin (16/25; 64{\%}) or a redo groin access (9/25; 36{\%}) were managed through the percutaneous remote access. In all patients, a percutaneous transluminal angioplasty balloon was used to predilate the scar tissue and the femoral artery or the synthetic vascular graft after preclosing (ProGlide{\^A}{\circledR}; Abbott Vascular, Santa Clara, CA, USA). In 10 patients, requiring a 20 Fr sheath, a 6 mm percutaneous transluminal angioplasty balloon was used; and in the remaining 15, requiring a 24 Fr sheath, an 8 mm percutaneous transluminal angioplasty balloon. Preclosing was exclusively performed using ProGlide{\^A}{\circledR}. Mean follow-up was 15 months. Results: In all cases, stent-graft deployment was successful. There was one surgical conversion (4{\%}; 1/25) due to bleeding from a femoral anastomosis. Two cases required additional percutaneous maneuvers (postclosing with another system in one patient and endoluminal shielding with stent-graft in the other patient). No pseudoaneurysm or access complication occurred during the follow-up. Conclusions: Percutaneous access in redo groins with scar tissue and/or synthetic vascular graft using ultrasound-guided punction, preclosing with ProGlide{\^A}{\circledR} system and predilation with percutaneous transluminal angioplasty balloon to introduce large size sheath as used for endovascular aortic repair showed to be feasible, safe and with few local complications.",
keywords = "80 and over; Angioplasty, Abdominal; Aortic Aneurysm, Aneurysm; balloon angioplasty; calcification; complications; endovascular aneurysm repair; infection; prosthetic graft; sheath; ultrasonography; vascular closure devices; Aged; Aged, Balloon; Aortic Aneurysm, Interventional; Vascular Access Devices; Surgery; Radiology, Nuclear Medicine and Imaging; Cardiology and Cardiovascular Medicine, Peripheral; Cicatrix; Equipment Design; Female; Groin; Humans; Male; Treatment Outcome; Ultrasonography, Thoracic; Blood Vessel Prosthesis; Blood Vessel Prosthesis Implantation; Catheterization",
author = "Felice Pecoraro and Felice Pecoraro and Veith, {Frank J} and Mario Lachat and Gilbert Puippe and Johnny Steuer and Mayur Krishnaswamy and Zoran Rancic and Nicola Mangialardi and Cayne, {Neal S} and Thomas Pfammatter",
year = "2017",
language = "English",
volume = "25",
pages = "396--401",
journal = "Vascular",
issn = "1708-5381",
publisher = "SAGE Publications Ltd",

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TY - JOUR

T1 - Predilation technique with balloon angioplasty to facilitate percutaneous groin access of large size sheath through scar tissue

AU - Pecoraro, Felice

AU - Pecoraro, Felice

AU - Veith, Frank J

AU - Lachat, Mario

AU - Puippe, Gilbert

AU - Steuer, Johnny

AU - Krishnaswamy, Mayur

AU - Rancic, Zoran

AU - Mangialardi, Nicola

AU - Cayne, Neal S

AU - Pfammatter, Thomas

PY - 2017

Y1 - 2017

N2 - Purpose: Percutaneous remote access for endovascular aortic repair is an advantageous alternative to open access. Previous surgery in the femoral region and the presence of synthetic vascular grafts in the femoral/iliac arteries represent major limitations to percutaneous remote access. The aim of this study was to evaluate an original technique used for enabling percutaneous remote access for thoracic or abdominal endovascular aortic repair in patients with scar tissue and/or a vascular graft in the groin. Methods: Twenty-five consecutive patients with a thoracic (11/25; 44%) or an aortic aneurysm (14/25; 66%) and with a synthetic vascular graft in the groin (16/25; 64%) or a redo groin access (9/25; 36%) were managed through the percutaneous remote access. In all patients, a percutaneous transluminal angioplasty balloon was used to predilate the scar tissue and the femoral artery or the synthetic vascular graft after preclosing (ProGlide®; Abbott Vascular, Santa Clara, CA, USA). In 10 patients, requiring a 20 Fr sheath, a 6 mm percutaneous transluminal angioplasty balloon was used; and in the remaining 15, requiring a 24 Fr sheath, an 8 mm percutaneous transluminal angioplasty balloon. Preclosing was exclusively performed using ProGlide®. Mean follow-up was 15 months. Results: In all cases, stent-graft deployment was successful. There was one surgical conversion (4%; 1/25) due to bleeding from a femoral anastomosis. Two cases required additional percutaneous maneuvers (postclosing with another system in one patient and endoluminal shielding with stent-graft in the other patient). No pseudoaneurysm or access complication occurred during the follow-up. Conclusions: Percutaneous access in redo groins with scar tissue and/or synthetic vascular graft using ultrasound-guided punction, preclosing with ProGlide® system and predilation with percutaneous transluminal angioplasty balloon to introduce large size sheath as used for endovascular aortic repair showed to be feasible, safe and with few local complications.

AB - Purpose: Percutaneous remote access for endovascular aortic repair is an advantageous alternative to open access. Previous surgery in the femoral region and the presence of synthetic vascular grafts in the femoral/iliac arteries represent major limitations to percutaneous remote access. The aim of this study was to evaluate an original technique used for enabling percutaneous remote access for thoracic or abdominal endovascular aortic repair in patients with scar tissue and/or a vascular graft in the groin. Methods: Twenty-five consecutive patients with a thoracic (11/25; 44%) or an aortic aneurysm (14/25; 66%) and with a synthetic vascular graft in the groin (16/25; 64%) or a redo groin access (9/25; 36%) were managed through the percutaneous remote access. In all patients, a percutaneous transluminal angioplasty balloon was used to predilate the scar tissue and the femoral artery or the synthetic vascular graft after preclosing (ProGlide®; Abbott Vascular, Santa Clara, CA, USA). In 10 patients, requiring a 20 Fr sheath, a 6 mm percutaneous transluminal angioplasty balloon was used; and in the remaining 15, requiring a 24 Fr sheath, an 8 mm percutaneous transluminal angioplasty balloon. Preclosing was exclusively performed using ProGlide®. Mean follow-up was 15 months. Results: In all cases, stent-graft deployment was successful. There was one surgical conversion (4%; 1/25) due to bleeding from a femoral anastomosis. Two cases required additional percutaneous maneuvers (postclosing with another system in one patient and endoluminal shielding with stent-graft in the other patient). No pseudoaneurysm or access complication occurred during the follow-up. Conclusions: Percutaneous access in redo groins with scar tissue and/or synthetic vascular graft using ultrasound-guided punction, preclosing with ProGlide® system and predilation with percutaneous transluminal angioplasty balloon to introduce large size sheath as used for endovascular aortic repair showed to be feasible, safe and with few local complications.

KW - 80 and over; Angioplasty

KW - Abdominal; Aortic Aneurysm

KW - Aneurysm; balloon angioplasty; calcification; complications; endovascular aneurysm repair; infection; prosthetic graft; sheath; ultrasonography; vascular closure devices; Aged; Aged

KW - Balloon; Aortic Aneurysm

KW - Interventional; Vascular Access Devices; Surgery; Radiology

KW - Nuclear Medicine and Imaging; Cardiology and Cardiovascular Medicine

KW - Peripheral; Cicatrix; Equipment Design; Female; Groin; Humans; Male; Treatment Outcome; Ultrasonography

KW - Thoracic; Blood Vessel Prosthesis; Blood Vessel Prosthesis Implantation; Catheterization

UR - http://hdl.handle.net/10447/251555

UR - http://www.uk.sagepub.com/journals/Journal202203?siteId=sage-uk&prodTypes=any&q=Vascular&fs=1

M3 - Article

VL - 25

SP - 396

EP - 401

JO - Vascular

JF - Vascular

SN - 1708-5381

ER -