Cargando…

Long-Term Evaluation of Percutaneous Groin Access for EVAR

BACKGROUND: Percutaneous endovascular aneurysm repair (PEVAR) has been shown to have high success rates, shorter operating times and length of stay compared to open access. However, there exists a lack of long-term follow-up data on these patients, and questions remain regarding longer-term outcomes...

Descripción completa

Detalles Bibliográficos
Autores principales: Dwivedi, Krit, Regi, John Mark, Cleveland, Trevor J., Turner, Douglas, Kusuma, Dan, Thomas, Steven M., Goode, Stephen D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6267668/
https://www.ncbi.nlm.nih.gov/pubmed/30288590
http://dx.doi.org/10.1007/s00270-018-2072-3
_version_ 1783376127846252544
author Dwivedi, Krit
Regi, John Mark
Cleveland, Trevor J.
Turner, Douglas
Kusuma, Dan
Thomas, Steven M.
Goode, Stephen D.
author_facet Dwivedi, Krit
Regi, John Mark
Cleveland, Trevor J.
Turner, Douglas
Kusuma, Dan
Thomas, Steven M.
Goode, Stephen D.
author_sort Dwivedi, Krit
collection PubMed
description BACKGROUND: Percutaneous endovascular aneurysm repair (PEVAR) has been shown to have high success rates, shorter operating times and length of stay compared to open access. However, there exists a lack of long-term follow-up data on these patients, and questions remain regarding longer-term outcomes. This study aims to assess the long-term complications and evolution of accessed vessels post-PEVAR. METHODS: Sixty-one cases of bilateral PEVAR (122 groins) with > 36 months follow-up were analysed. Vessel diameter, calcification, dissection, lymphocele, pseudoaneurysm and thrombus formation were reviewed at 30th day and at the most recent follow-up CT. Notes were reviewed for groin infections, haematomas and nerve injury. Complications were considered ‘major’ if they required intervention or treatment. RESULTS: Mean follow-up time from procedure to most recent scan was 49.9 months. There were no major short- or long-term complications. The early complication rate was 9.8%, with six pseudoaneurysms, four dissections, one thrombus, one nerve injury and no lymphoceles, haematomas or groin infections. The long-term complication rate was 0.8%, with only one pseudoaneurysm. The remainder of early complications resolved naturally without intervention. Accessed vessel showed significantly (P ≤ 0.05) increased diameter and calcification between 30th day and last follow-up scan. CONCLUSION: This study provides the largest clinical cohort and the longest mean follow-up time reported in the literature and demonstrates the long-term safety of PEVAR. PEVAR has a very low long-term complication rate, without any major complications in our cohort. The accessed common femoral arteries do not show stenosis or thrombosis. Minor short-term complications appear to gradually resolve without intervention. Larger multi-centre studies are recommended.
format Online
Article
Text
id pubmed-6267668
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher Springer US
record_format MEDLINE/PubMed
spelling pubmed-62676682018-12-18 Long-Term Evaluation of Percutaneous Groin Access for EVAR Dwivedi, Krit Regi, John Mark Cleveland, Trevor J. Turner, Douglas Kusuma, Dan Thomas, Steven M. Goode, Stephen D. Cardiovasc Intervent Radiol Clinical Investigation BACKGROUND: Percutaneous endovascular aneurysm repair (PEVAR) has been shown to have high success rates, shorter operating times and length of stay compared to open access. However, there exists a lack of long-term follow-up data on these patients, and questions remain regarding longer-term outcomes. This study aims to assess the long-term complications and evolution of accessed vessels post-PEVAR. METHODS: Sixty-one cases of bilateral PEVAR (122 groins) with > 36 months follow-up were analysed. Vessel diameter, calcification, dissection, lymphocele, pseudoaneurysm and thrombus formation were reviewed at 30th day and at the most recent follow-up CT. Notes were reviewed for groin infections, haematomas and nerve injury. Complications were considered ‘major’ if they required intervention or treatment. RESULTS: Mean follow-up time from procedure to most recent scan was 49.9 months. There were no major short- or long-term complications. The early complication rate was 9.8%, with six pseudoaneurysms, four dissections, one thrombus, one nerve injury and no lymphoceles, haematomas or groin infections. The long-term complication rate was 0.8%, with only one pseudoaneurysm. The remainder of early complications resolved naturally without intervention. Accessed vessel showed significantly (P ≤ 0.05) increased diameter and calcification between 30th day and last follow-up scan. CONCLUSION: This study provides the largest clinical cohort and the longest mean follow-up time reported in the literature and demonstrates the long-term safety of PEVAR. PEVAR has a very low long-term complication rate, without any major complications in our cohort. The accessed common femoral arteries do not show stenosis or thrombosis. Minor short-term complications appear to gradually resolve without intervention. Larger multi-centre studies are recommended. Springer US 2018-10-04 2019 /pmc/articles/PMC6267668/ /pubmed/30288590 http://dx.doi.org/10.1007/s00270-018-2072-3 Text en © The Author(s) 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Clinical Investigation
Dwivedi, Krit
Regi, John Mark
Cleveland, Trevor J.
Turner, Douglas
Kusuma, Dan
Thomas, Steven M.
Goode, Stephen D.
Long-Term Evaluation of Percutaneous Groin Access for EVAR
title Long-Term Evaluation of Percutaneous Groin Access for EVAR
title_full Long-Term Evaluation of Percutaneous Groin Access for EVAR
title_fullStr Long-Term Evaluation of Percutaneous Groin Access for EVAR
title_full_unstemmed Long-Term Evaluation of Percutaneous Groin Access for EVAR
title_short Long-Term Evaluation of Percutaneous Groin Access for EVAR
title_sort long-term evaluation of percutaneous groin access for evar
topic Clinical Investigation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6267668/
https://www.ncbi.nlm.nih.gov/pubmed/30288590
http://dx.doi.org/10.1007/s00270-018-2072-3
work_keys_str_mv AT dwivedikrit longtermevaluationofpercutaneousgroinaccessforevar
AT regijohnmark longtermevaluationofpercutaneousgroinaccessforevar
AT clevelandtrevorj longtermevaluationofpercutaneousgroinaccessforevar
AT turnerdouglas longtermevaluationofpercutaneousgroinaccessforevar
AT kusumadan longtermevaluationofpercutaneousgroinaccessforevar
AT thomasstevenm longtermevaluationofpercutaneousgroinaccessforevar
AT goodestephend longtermevaluationofpercutaneousgroinaccessforevar