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Fascia suturing of ...
Fascia suturing of large access sites after endovascular treatment of aortic aneurysms and dissections
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- Larzon, Thomas (author)
- Örebro universitet,Institutionen för klinisk medicin
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Geijer, Håkan (author)
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Gruber, Göran (author)
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Popek, Robert (author)
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Norgren, Lars (author)
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(creator_code:org_t)
- 2006
- 2006
- English.
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In: Journal of Endovascular Therapy. - 1526-6028 .- 1545-1550. ; 13:2, s. 152-157
- Related links:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- PURPOSE: To evaluate a technique for closure of a femoral artery access in which the cribriform fascia covering the common femoral artery is sutured.METHODS: A consecutive series of 127 patients (103 men; median age 74 years, range 45- 89) underwent endovascular aortic aneurysm repair between August 2001 and September 2004. Twelve patients underwent a secondary intervention for a total of 139 procedures in the group. Sixty-one (43.9%) of the 139 operations were acute. Among the 257 femoral arteries used for access, a fascia suturing technique was performed in 131 (51.0%). Data were collected for analysis of access site complications, bleeding, thrombosis, pseudoaneurysm, and stenosis. A subgroup of 72 patients had ankle-brachial indexes (ABI) recorded; another subgroup of 50 patients were also investigated by duplex ultrasonography.RESULTS: Complications occurred in 18 (13.7%) of the 131 sutured cases. The majority (n = 16) arose within 24 hours: 8 cases of perioperative bleeding or thrombosis required open surgery and 8 cases were reoperated within 24 hours for bleeding (n = 4), thrombosis (n = 3), and 1 intimal dissection. The acute failure rate was 12.2%. Two patients had late complications: 1 case of neuralgia and 1 pseudoaneurysm that required acute surgery 28 months postoperatively. The ABI did not change significantly from pre- to postoperatively in the 72 patients examined. Five patients with stenoses did not have a reduction in ABI. In the 66 sites examined with ultrasound in 50 patients, 3 minor pseudoaneurysms were detected.CONCLUSION: The fascia suturing technique for closure of a femoral artery access during endovascular repair of aortic diseases is feasible, even in acute situations. Failures can be managed easily. Late complications requiring additional procedures are rare.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
Keyword
- Kirurgi
- Surgery
Publication and Content Type
- ref (subject category)
- art (subject category)
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