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A comparative study between surgical cut down and percutaneous closure devices in management of large bore arterial access

BACKGROUND: Compared to conventional open surgery, minimally invasive catheter-based procedures have less post procedural complications. Transcatheter aortic valve implantation (TAVI) and endovascular aneurysm repair (EVAR) require large bore arterial access. Optimal site management of large bore ar...

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Autores principales: Mousa, Mohamed Ahmed, Zahwy, Sherif Samir El, Tamara, Ahmed Fathy, Samir, Wafed, Tantawy, Mahmoud Ahmed
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10613603/
https://www.ncbi.nlm.nih.gov/pubmed/37899370
http://dx.doi.org/10.1186/s42155-023-00395-6
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author Mousa, Mohamed Ahmed
Zahwy, Sherif Samir El
Tamara, Ahmed Fathy
Samir, Wafed
Tantawy, Mahmoud Ahmed
author_facet Mousa, Mohamed Ahmed
Zahwy, Sherif Samir El
Tamara, Ahmed Fathy
Samir, Wafed
Tantawy, Mahmoud Ahmed
author_sort Mousa, Mohamed Ahmed
collection PubMed
description BACKGROUND: Compared to conventional open surgery, minimally invasive catheter-based procedures have less post procedural complications. Transcatheter aortic valve implantation (TAVI) and endovascular aneurysm repair (EVAR) require large bore arterial access. Optimal site management of large bore arterial access is pivotal to reduce the hospital-acquired complications associated with large bore arterial access. We wanted to compare surgical cutdown versus percutaneous closure devices in site management of large bore arterial access. METHODS: Participants planned for TAVI or EVAR with large bore arterial access more than 10 French were included, while participants with history of bypass surgery, malignancies, thrombophilia, or sepsis were excluded. A consecutive sample of 100 participants (mean age 74.66 ± 2.65 years, 61% males) was selected, underwent TAVI or EVAR with surgical cutdown (group 1) versus TAVI or EVAR with Proglide™ percutaneous closure device (group 2). RESULTS: The incidence rate of hematoma was significantly lower in group 2 versus group 1 (p = 0.014), the mean procedure time (minutes) and the median hospital stay (days) were significantly higher in group 1 versus group 2 (t(98) =  − 2.631, p = 0.01, and U = 2.403, p = 0.018, respectively), and the c-reactive protein pre-procedure and the c-reactive protein post-procedure were significantly lower in group 2 versus group 1 (U = -2.969, p = 0.003, and U = -2.674, p = 0.007, respectively). CONCLUSIONS: Our study showed a lower incidence rate of large bore arterial access complications as hematoma, a shorter procedure time, and a shorter hospital stay with percutaneous closure devices compared to surgical cutdown.
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spelling pubmed-106136032023-10-31 A comparative study between surgical cut down and percutaneous closure devices in management of large bore arterial access Mousa, Mohamed Ahmed Zahwy, Sherif Samir El Tamara, Ahmed Fathy Samir, Wafed Tantawy, Mahmoud Ahmed CVIR Endovasc Original Article BACKGROUND: Compared to conventional open surgery, minimally invasive catheter-based procedures have less post procedural complications. Transcatheter aortic valve implantation (TAVI) and endovascular aneurysm repair (EVAR) require large bore arterial access. Optimal site management of large bore arterial access is pivotal to reduce the hospital-acquired complications associated with large bore arterial access. We wanted to compare surgical cutdown versus percutaneous closure devices in site management of large bore arterial access. METHODS: Participants planned for TAVI or EVAR with large bore arterial access more than 10 French were included, while participants with history of bypass surgery, malignancies, thrombophilia, or sepsis were excluded. A consecutive sample of 100 participants (mean age 74.66 ± 2.65 years, 61% males) was selected, underwent TAVI or EVAR with surgical cutdown (group 1) versus TAVI or EVAR with Proglide™ percutaneous closure device (group 2). RESULTS: The incidence rate of hematoma was significantly lower in group 2 versus group 1 (p = 0.014), the mean procedure time (minutes) and the median hospital stay (days) were significantly higher in group 1 versus group 2 (t(98) =  − 2.631, p = 0.01, and U = 2.403, p = 0.018, respectively), and the c-reactive protein pre-procedure and the c-reactive protein post-procedure were significantly lower in group 2 versus group 1 (U = -2.969, p = 0.003, and U = -2.674, p = 0.007, respectively). CONCLUSIONS: Our study showed a lower incidence rate of large bore arterial access complications as hematoma, a shorter procedure time, and a shorter hospital stay with percutaneous closure devices compared to surgical cutdown. Springer International Publishing 2023-10-30 /pmc/articles/PMC10613603/ /pubmed/37899370 http://dx.doi.org/10.1186/s42155-023-00395-6 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Article
Mousa, Mohamed Ahmed
Zahwy, Sherif Samir El
Tamara, Ahmed Fathy
Samir, Wafed
Tantawy, Mahmoud Ahmed
A comparative study between surgical cut down and percutaneous closure devices in management of large bore arterial access
title A comparative study between surgical cut down and percutaneous closure devices in management of large bore arterial access
title_full A comparative study between surgical cut down and percutaneous closure devices in management of large bore arterial access
title_fullStr A comparative study between surgical cut down and percutaneous closure devices in management of large bore arterial access
title_full_unstemmed A comparative study between surgical cut down and percutaneous closure devices in management of large bore arterial access
title_short A comparative study between surgical cut down and percutaneous closure devices in management of large bore arterial access
title_sort comparative study between surgical cut down and percutaneous closure devices in management of large bore arterial access
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10613603/
https://www.ncbi.nlm.nih.gov/pubmed/37899370
http://dx.doi.org/10.1186/s42155-023-00395-6
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