Ultrasound-guided fascia closure as bailout technique for large-bore percutaneous femoral access failure: Report of two cases.

Ultrasound-guided fascia closure as bailout technique for large-bore percutaneous femoral access failure: Report of two cases. J Vasc Access. 2020 Feb 22;:1129729820906975 Authors: Baldino G, Rossi UG, Di Gregorio S, Gori A Abstract Percutaneous endovascular abdominal aortic aneurysm repair is nowadays considered a safe and effective procedure and has gained widespread globally acceptance. However, intraoperative persistent bleeding due to percutaneous access closure device failure can occur. Open conversion is first-line treatment to manage this complication. The fascia suture technique was introduced as an alternative to access closure device or as a solution to manage unsatisfactory hemostasis during percutaneous endovascular abdominal aortic aneurysm repair. In this article, we report a new simple minimally invasive ultrasound-guided fascia suture technique as a bailout method to manage persistent bleeding after percutaneous endovascular abdominal aortic aneurysm repair avoiding open conversion. This technique was successfully used in two cases at our center with satisfactory hemostasis and no further complications. Ultrasound-guided fascia suture technique can be proposed as a minimally invasive bailout technique for access closure device failure. PMID: 32089061 [PubMed - as supplied by publisher]
Source: The Journal of Vascular Access - Category: Surgery Tags: J Vasc Access Source Type: research

Related Links:

AbstractGuidelines advice against dual antiplatelet therapy (DAPT) discontinuation less than 12  months after percutaneous coronary intervention with drug-eluting stents (DES-PCI). However, any delay of necessary surgery in patients with descending thoracic (DTA) or abdominal aortic aneurysm (AAA), treated by DES-PCI, increases the risk of aneurysm rupture/dissection. We evaluated the safety of 8-week waiting time between DES-PCI and endovascular aortic repair (EVAR). 1152 consecutive patients with coronary artery disease (CAD) needing elective DTA or AAA repair were enrolled and divided into two groups. Group A inclu...
Source: Updates in Surgery - Category: Surgery Source Type: research
Abstract OBJECTIVE: Long term survival after endovascular aortic aneurysm repair (EVAR) in octogenarians remains unclear. This was evaluated by comparing octogenarians after EVAR with a matched group of octogenarians without an abdominal aortic aneurysm (AAA) from the Rotterdam Study (RS). The influence of complications after EVAR on survival was also studied with the aim of identifying risk factors for the development of complications in octogenarians. METHODS: Using propensity score matching (PSM), 83 EVAR octogenarians were matched for comorbidities with 83 octogenarians from the RS, and survival was compa...
Source: PubMed: Eur J Vasc Endovasc ... - Category: Surgery Authors: Tags: Eur J Vasc Endovasc Surg Source Type: research
Introduction: Almost all vascular surgeons use a bolus of 5 000 IU of unfractionated heparin (UFH). However, its dose-response and elimination curves are non-linear, and display a high inter-patient variability. The activated clotting time (ACT) is an established method to measure the level of anticoagulation. The purpose of this study was to evaluate the rate of arterial thrombo-embolic complications (ATEC) and bleeding complications in patients undergoing elective open abdominal aortic aneurysm repair (AAA), in which a bolus of 5 000 IU of UFH was compared to an ACT guided additional UFH dose protocol.
Source: European Journal of Vascular and Endovascular Surgery - Category: Surgery Authors: Source Type: research
Aortoenteric fistula (AEF) is a rare cause of gastrointestinal (GI) bleeding. If not promptly diagnosed and treated the associated mortality is very high. The role of endovascular treatment is not yet defined. In this paper we report a clinical case of a 94-year-old male admitted in the emergency department with rectal bleeding. Due to detection of a pulsatile abdominal mass, a computed tomography angiography (CTA) scan was performed, which established the diagnosis of aorto-enteric fistula due to a left common iliac artery aneurysm (CIAA) ruptured to the sigmoid colon and also revealed an abdominal aortic aneurysm (AAA) a...
Source: Annals of Vascular Surgery - Category: Surgery Authors: Tags: Case Report Source Type: research
Primary aortoenteric fistulas are rare, with the annual incidence of such fistulas estimated to be 0.007 per million. The most common predisposing conditions for primary aortoenteric fistulas are atherosclerotic abdominal aortic aneurysms or penetrating atherosclerotic ulcers. We illustrate a rare case of an inflammatory aortic aneurysm causing a primary aortic fistula, with a direct fistulous jet from the aorta to the bowel with resultant catastrophic bleeding. In contrast to atherosclerotic aneurysms, most inflammatory aneurysms are symptomatic and show dense perianeurysmal fibrosis and periaortic wall thickening. A dire...
Source: Journal of Radiology Case Reports - Category: Radiology Source Type: research
k M Abstract OBJECTIVES: Abdominal compartment syndrome (ACS) is a serious complication after abdominal aortic aneurysm (AAA) repair. The aim was to investigate outcome among subgroups and factors associated with outcome, with emphasis on the duration of intra-abdominal hypertension before treatment. METHODS: Since 2008, ACS and decompressive laparotomy (DL) after AAA repair are registered prospectively in the Swedish vascular registry (Swedvasc). Registry data and case records were reviewed. Subgroups were defined by main pathophysiological finding at DL, timing of DL after AAA repair, and treatment modality...
Source: PubMed: Eur J Vasc Endovasc ... - Category: Surgery Authors: Tags: Eur J Vasc Endovasc Surg Source Type: research
Open repair of thoraco-abdominal aortic aneurysm (TAAA) is a challenging procedure, associated with high rates of peri-operative bleeding and blood product transfusions. A large intra-operative volume transfusion has been associated with higher in hospital mortality and prolonged mechanical ventilation. A propensity score matched study was carried out to assess whether the introduction of a rotational thromboelastometry (ROTEM) based transfusion strategy reduces allogenic blood transfusion and affects morbidity in patients undergoing open TAAA repair.
Source: Journal of Vascular Surgery - Category: Surgery Authors: Tags: Selected Abstract from the July Issue of the European Journal of Vascular and Endovascular Surgery Source Type: research
Abstract OBJECTIVE: Open repair of thoraco-abdominal aortic aneurysm (TAAA) is a challenging procedure, associated with high rates of peri-operative bleeding and blood product transfusions. A large intra-operative volume transfusion has been associated with higher in hospital mortality and prolonged mechanical ventilation. A propensity score matched study was carried out to assess whether the introduction of a rotational thromboelastometry (ROTEM) based transfusion strategy reduces allogenic blood transfusion and affects morbidity in patients undergoing open TAAA repair. METHODS: All patients undergoing open ...
Source: PubMed: Eur J Vasc Endovasc ... - Category: Surgery Authors: Tags: Eur J Vasc Endovasc Surg Source Type: research
An aortoesophageal fistula, an abnormal anatomical communication between the aorta and the esophagus, is a rare cause of upper gastrointestinal bleeding. The mortality rate of patients with this condition is very high. A 77-year-old man, who had undergone endovascular aortic repair for a ruptured abdominal aortic aneurysm, developed melena. An upper gastrointestinal endoscopy was performed. This detected an esophageal ulcer, which had the potential to develop into an aortoesophageal fistula. Therefore, thoracic endovascular aortic repair was performed on the following day. Thereafter, the course was uneventful. We encounte...
Source: Case Reports in Gastroenterology - Category: Gastroenterology Source Type: research
Abstract Abdominal aortic aneurysm (AAA) is a vascular disease characterized by the enlargement of the infrarenal segment of the aorta. A ruptured AAA can cause internal bleeding and carries a high mortality rate, which is why the clinical management of the disease is focused on preventing aneurysm rupture. AAA rupture risk is estimated by the change in maximum diameter over time (i.e., growth rate) or if the diameter reaches a prescribed threshold. The latter is typically 5.5 cm in most clinical centers, at which time surgical intervention is recommended. While a size-based criterion is suitable for most pat...
Source: Annals of Biomedical Engineering - Category: Biomedical Engineering Authors: Tags: Ann Biomed Eng Source Type: research
More News: Abdominal Aneurysm Repair | Abdominal Aortic Aneurysm | Aortic Aneurysm | Bleeding | Gastroschisis Repair | Surgery | Ultrasound