The Role of Downsizing of Large-Bore Percutaneous Femoral Access for Pelvic and Lower Limb Perfusion in Transfemoral Branched Endovascular Aortic Repair
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Cohort
2.2. Access Technique and Downsizing
2.3. Parameters’ Assessment
2.4. Data Collection
2.5. Definitions
2.6. Outcomes
2.7. Statistical Analysis
3. Results
3.1. Patient Cohort
3.2. Limb Perfusion Reduction
4. Discussion
Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variable | Total n = 24 |
---|---|
Age, years | 69 (64–78) |
Male, n (%) | 17 (71) |
Coronary artery disease, n (%) | 9 (38) |
Atrial fibrillation, n (%) | 5 (21) |
Myocardial infarction, n (%) | 3 (13) |
Chronic heart failure, n (%) | 5 (21) |
Hypertension, n (%) | 18 (75) |
Dyslipidemia, n (%) | 4 (17) |
Smoker, n (%) | 7 (29) |
Chronic obstructive pulmonary disease, n (%) | 2 (8) |
Diabetes, n (%) | 2 (8) |
Renal insufficiency, n (%) | 9 (38) |
Basal glomerular filtration rate, mL/min | 53 (29–74) |
Stroke, n (%) | 2 (8) |
Peripheral artery disease, n (%) | 4 (17) |
Body mass index, kg/m2 | 25 (23–29) |
Aneurysm type | |
Type I, n (%) | 3 (13) |
Type II, n (%) | 6 (25) |
Type III, n (%) | 3 (13) |
Type IV, n (%) | 2 (8) |
Pararenal, n (%) | 10 (42) |
Baseline | Phase 1 | Phase 2 | Phase 3 | Postop | |
---|---|---|---|---|---|
Phase description | Access preparation | Branched graft deployment | Transfemoral TV catheterization and stenting | ||
Sheath size (F) | 10F | 20F–22F | 14F | ||
Duration in min, Median (IQR) | NR | 20 (15–30) | 30 (15–30) | 125 (105–190) | NR |
ABPI, Median (IQR) [n] | 1.05 (1–1.13) [24] | 0.96 (0.86–1.08) [23] | 0.63 (0.6–0.88) [3] | 0.78 (0.63–0.83) [21] | 1.01 (0.95–1.09) [24] |
SpO2 (%), Median (IQR) [n] | 100 (100–100) [24] | 100 (97–100) [23] | 97 (71–99.5) [4] | 100 (99–100) [21] | 100 (100–100) [24] |
LPR incidence, [n] % | 1 4.2 | 21 87.5 | 3 12.6 | 0 0.0 |
Recovered LPR | Persistent LPR | p | |
---|---|---|---|
n (%) | 18 (85.7%) | 3 (14.3%) | |
EIA diameter (cm) | 0.95 (IQR: 0.9–1.1) | 0.9 (IQR: 0.8–1.0) | 0.32 |
CIA diameter (cm) | 1.3 (IQR: 1.2–1.4) | 1.3 (IQR: 1.2–1.5) | 0.81 |
HA occlusion | 3 (16.7%) | 3 (100%) | 0.009 |
SCI | 3 (16.7%) | 1 (33%) | 0.49 |
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Sarhan, D.Y.A.; Kölbel, T.; Grandi, A.; Nana, P.; Torrealba, J.I.; Behrendt, C.-A.; Panuccio, G. The Role of Downsizing of Large-Bore Percutaneous Femoral Access for Pelvic and Lower Limb Perfusion in Transfemoral Branched Endovascular Aortic Repair. J. Clin. Med. 2024, 13, 5375. https://doi.org/10.3390/jcm13185375
Sarhan DYA, Kölbel T, Grandi A, Nana P, Torrealba JI, Behrendt C-A, Panuccio G. The Role of Downsizing of Large-Bore Percutaneous Femoral Access for Pelvic and Lower Limb Perfusion in Transfemoral Branched Endovascular Aortic Repair. Journal of Clinical Medicine. 2024; 13(18):5375. https://doi.org/10.3390/jcm13185375
Chicago/Turabian StyleSarhan, Daour Yousef Al, Tilo Kölbel, Alessandro Grandi, Petroula Nana, José I. Torrealba, Christian-Alexander Behrendt, and Giuseppe Panuccio. 2024. "The Role of Downsizing of Large-Bore Percutaneous Femoral Access for Pelvic and Lower Limb Perfusion in Transfemoral Branched Endovascular Aortic Repair" Journal of Clinical Medicine 13, no. 18: 5375. https://doi.org/10.3390/jcm13185375