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2015 ; 32
(3
): 278-88
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Current Status of Percutaneous Endografting
#MMPMID26327747
Patel PJ
; Kelly Q
; Hieb RA
; Lee CJ
Semin Intervent Radiol
2015[Sep]; 32
(3
): 278-88
PMID26327747
show ga
Totally percutaneous endovascular abdominal aortic aneurysm repair (PEVAR) using
suture-mediated closure devices (SMCDs) has several well-established advantages
over standard open femoral exposure as a direct consequence of being less
invasive and having shorter times to hemostasis and procedure completion. The
first multicenter randomized controlled trial designed to assess the safety and
efficacy of PEVAR and to compare percutaneous access with standard open femoral
exposure was recently published (the PEVAR trial). The PEVAR trial demonstrated
that percutaneous endografting is safe, effective, and noninferior to standard
open femoral exposure among trained operators. The study reaffirmed the results
of several recent single center and nonrandomized studies, demonstrating that
percutaneous access facilitated shorter procedures, shorter times to secure
hemostasis, and improved quality of life for patients. As PEVAR has gained
popularity among patients and physicians, refinements to the technique and
patient selection process have been made. There has been growing interest in
treating patients with anatomical characteristics previously thought to be
unsuitable for PEVAR, such as common femoral artery (CFA) calcifications, scarred
groins, small CFA diameter, and high patient body mass index (BMI). However,
observance of strict procedural technique and consideration for patient selection
criteria remain paramount in achieving acceptable technical success rates with
PEVAR.