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Purpose <p>To describe the downsizing post-closure technique for access hemostasis during emergency endovascular repair (EVAR) in ruptured abdominal aortic aneurysms (RAAA).</p> Materials and Methods <p>A cohort of eight patients underwent emergency EVAR through 16 femoral access sites for infrarenal RAAA. The downsizing post-closure technique, which involves a reduction in the size of the large-bore access by advancing a 10F sheath, was consistently applied. Technical success was defined as complete hemostasis without a bailout intervention. Primary outcome measure was the incidence of access-related complications. Secondary outcome measures included manual compression time, hemostasis time, hospital stay, additional use of Proglide, and the 30-day mortality rate.</p> Results <p>The technique&#xa0;resulted in a 100% success rate (mean age: 69.5 ± 11.7&#xa0;years; 75% males). The mean arterial sheath size was 18.1 ± 1.9F. The mean manual compression time was 3.6 ± 1.2&#xa0;min, and the mean hemostasis time was 6.8 ± 1.4&#xa0;min. No patients required additional use of Proglide, and no access-related complications were observed. The 30-day mortality rate was 12.5%.</p> Conclusions <p>The downsizing post-closure technique may offer an alternative for access hemostasis during emergency EVAR for RAAA. However, further evaluations through larger comparative studies are required.</p> Graphical Abstract <MediaObject ID="MO2"> <ImageObject Color="Color" FileRef="MediaObjects/270_2024_3952_Figa_HTML.png" Format="PNG" Height="1142" Rendition="HTML" Resolution="300" Type="LinedrawHalftone" Width="2030" /> </MediaObject>

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Post-closure Technique for Access Hemostasis During Emergency Endovascular Repair in Ruptured Abdominal Aortic Aneurysms: Technical Note on a Preliminary Experience

  • 期刊论文

  • 发表日期：

    2025年1月9日

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  • Chen Xu,
  • Guo-xiong Xu,
  • Lei Chen,
  • Yi-qi Jin

摘要

Purpose

To describe the downsizing post-closure technique for access hemostasis during emergency endovascular repair (EVAR) in ruptured abdominal aortic aneurysms (RAAA).

Materials and Methods

A cohort of eight patients underwent emergency EVAR through 16 femoral access sites for infrarenal RAAA. The downsizing post-closure technique, which involves a reduction in the size of the large-bore access by advancing a 10F sheath, was consistently applied. Technical success was defined as complete hemostasis without a bailout intervention. Primary outcome measure was the incidence of access-related complications. Secondary outcome measures included manual compression time, hemostasis time, hospital stay, additional use of Proglide, and the 30-day mortality rate.

Results

The technique resulted in a 100% success rate (mean age: 69.5 ± 11.7 years; 75% males). The mean arterial sheath size was 18.1 ± 1.9F. The mean manual compression time was 3.6 ± 1.2 min, and the mean hemostasis time was 6.8 ± 1.4 min. No patients required additional use of Proglide, and no access-related complications were observed. The 30-day mortality rate was 12.5%.

Conclusions

The downsizing post-closure technique may offer an alternative for access hemostasis during emergency EVAR for RAAA. However, further evaluations through larger comparative studies are required.

Graphical Abstract