Clinical application of Perclose ProGlide suture homeostasis device after endovascular graft exclusion for aortic dissection

Abstract:

Objective：To evaluate the safety and reliability of applying Perclose ProGlide suture homeostasis device（Abbott，USA） after percutaneous femoral artery puncture and endovascular graft exclusion（EVGE） for aortic dissection. Methods：Totally 200 patients with Stanford type B aortic dissection from 2004 to 2012 in our hospital were enrolled and were randomized into control group（n=100） and observation group（n=100） according to EVGE for aortic dissection under local anesthesia or general anesthesia. Skin in in－guinal region of patients in control group was longitudinally incised 4.0-6.0 cm and was exposed 2.0-3.0 cm；femoral artery puncture was performed soon to establish femoral artery path. Patients in observation group underwent femoral artery puncture to establish femoral artery path and two sets of Perclose ProGlide devices were conventionally used after the operation. Results：Success rate of two sets of Perclose ProGlide suture devices in observation group was 95.0%（95/100）. Operation time in control group and observation group was （113.0±16.0） min and （90.0±12.1） min respectively，with significant statistical differences（P<0.01）. Femoral artery path establishment time was （14.0±1.3） min and （4.3±0.8） min respectively，with significant statistical differences（P<0.01）. Vascu－lar processing time after exiting the sheath was （8.9±1.3） min and （3.0±0.7） min respectively，with significant statistical differ－ences（P<0.01）. Postoperative braking time was （18.5±1.9） h and （7.7±2.3） h respectively，with significant statistical differences（P<0.01）. Postoperative average hospitalization time was （5.2±1.0） d and （3.3 ± 0.8） d respectively，with significant statisti－cal differences（P<0.01）. Complications incidences were 5% and 4% respectively，without statistically differences（P >0.05）. Wound discomfort was respectively observed in 36 cases（36.0%） and 17 cases（17.0%），with significant statistically differences（P<0.01）. Conclusions：Clinical application of the Perclose ProGlide suture hemostasis device after EVGE for aortic dissection is a safe and reliable method，which can reduce operation time，femoral artery path establishment time，vascular processing time after exiting the sheath，brake time，postoperative hospitalization time with low complication incidences.