Percutaneous suture-mediated closure versus surgical XXXX repair.

@entity1 @entity449 @entity28 @entity2080 @entity729 @entity2849
PURPOSE: To compare percutaneous suture-mediated closure (PSMC) with surgical closure in endovascular @entity449 repair and examine the influence of @entity28 , sheath size, and vessel calcification on the effectiveness of percutaneous closure. MATERIALS AND METHODS: A total of 445 @entity1 (mean age, 75.9    7.6 years) undergoing @entity449 repair from 2003 to 2010 were retrospectively reviewed. A total of 100 PSMC and 557 surgical closures for arteriotomies with sheath sizes between 12 F and 18 F were compared in terms of failure, complications, and operating room time. Additionally, effects of @entity729 , body mass index, and sheath size on PSMC were evaluated. RESULTS: Eighty-five percent of PSMCs were successful. Failure was attributed to lack of hemostasis in 11 and difficulty in device positioning in four cases. Complication rate after successful PSMC (9.4%) was significantly less than surgery (19.4%) (P = .02).When failed PSMC cases were considered as complication, the complication rate was not different between the two groups (P = .4). @entity2080 occurred more after surgical closures (11.4% vs 1.2%; P = .001). @entity2849 occurred more after PSMC (3.5% vs 0.18%; P = .008).Average PSMC procedure time was less than that of surgical closure (P = .0001). PSMC success rate was 89.7% for < 16-F sheaths and 80.4% for >=  16-F sheaths (P = .15). PSMC success was not different between @entity28 and nonobese @entity1 (P = .22). PSMC success in calcified and noncalcified arteries was not different (P = .37). CONCLUSIONS: PSMC is an effective arterial closure method. It is faster and associated with less postprocedure morbidity than surgery. Appropriate technique and meticulous vascular exposure affect PSMC success. Obesity, @entity729 , and sheath size did not change PSMC outcome in this study.
