Cardiovascular Surgery and Interventions 2015, Vol 2, Num 3 Page(s): 049-053
Total percutaneous access versus surgical access in endovascular procedures: a retrospective analysis

Ünal Aydın, Ebru Bal Polat, Onur Şen, Ersin Kadiroğulları, Mehmet Kaya, Korhan Erkanlı, İhsan Bakır

Department of Cardiovascular Surgery, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey

Keywords: Endovascular intervention; percutaneous approach; surgery
Objectives: This study aims to compare the outcomes of total percutaneous and surgical access methods in endovascular interventions.

Patients and methods: The results of endovascular aortic repair (EVAR) of abdominal aortic aneurysms were retrospectively analyzed. One hundred and four patients (76 males, 28 females; mean age 67.0±8.4 years; range 31 to 84 years) were operated for EVAR between October 2010 and June 2014. In 55 patients (52.9%), EVAR was performed percutaneously and access repair was made with vascular closure device. In 49 (47%), surgical cut-down was performed.

Results: There was a statistically significant difference in the frequency of chronic obstructive pulmonary disease between the groups, indicating a higher incidence in the percutaneous group (40.0% vs. 20.4%, p=0.031). Obese patients were shown to have a higher incidence of complications. A higher number of obese patients undergoing percutaneous closure developed hematoma (7.7% vs. 50.0%, p=0.0001). Vascular repair was also significantly more frequent in the percutaneous group with a more pronounced difference in obese patients (0 vs. 43.8%, p=0.005).

Conclusion: Pre-close technique is a successful way of performing EVAR procedures. Although wound infections are less common, obese patients may have higher rates of complications with percutaneous technique.

DOI : 10.5606/e-cvsi.2015.432