In our series, closure was successfully accomplished in 304 of 308 patients (98%). Additional manual compression was necessary in 18 (7%) for more than 10 minutes. Four patients needed surgical closure of the puncture hole. Follow-up examinations with ultrasound showed six pseudoaneurysms. Five of them weretreated with ultrasound-guided compression. In one patient, compression failed to build a thrombus with occlusion of the false aneurysm. The patient was referred to vascular surgery, but a control examinationon the planned day of surgery revealed a spontaneous occlusion of the false aneurysm. Surgical correction was no longer necessary. With such a high success rate of arterial closure afterEVAR, we routinely do not need any surgical backup.EVAR has become a percutaneous procedure for the majority of our patients. Future developments with downsizing of the endograft catheters to 16 F will make it even safer to perform EVAR percutaneously. Mathias 2009 (Ακτινολόγος)
Papazoglou K, Christu K, Iordanides T, Balitas A, Giakoystides D, Giakoystides E, et al. Endovascular abdominal aortic aneurysm repair with percutaneous transfemoral prostheses deployment under local anaesthesia. Initial experience with a new, simple-to-use tubular and bifurcated device in the first 27 cases. Eur J Vasc Endovasc Surg 1999;17:202-7. Local anesthesia for endovascular abdominal aortic aneurysm repair. E. L. G. Verhoeven, MD,a C. S. Cinà, MD, FRCSC, MSc (HRM),e I. F. J. Tielliu, MD,a C. J. Zeebregts, MD, PhD,a T. R. Prins, MD,b G. B. Eindhoven, MD,c M. M. Span, PhD,d M. R. Kapma, MD,a and J. J. A. M. van den Dungen, MD, PhD,a Groningen, The Netherlands and Hamilton, Ontario, Canada ( J Vasc Surg 2005;42:402-9.) LA was associated with a lower incidence of complications compared with GA (P <.001). In the LA group, two patients had to be converted to GA, one because of a dissection and one because of anxiety. In 13% of the patients in the LA group, additional intravenous sedation or analgesia was required. Operating time and length of stay in intensive care was shorter in the LA and RA groups than in the GA group (P <.001). Length of stay in hospital and time to ambulation and regular diet was shorter in the LA group compared with the RA and GA groups (P <.001).