Abstract
Objective
This study aimed to assess the long-term complications and evolution of groin access using the sequential suture and plug vascular closure devices (VCDs) technique during endovascular aneurysm repair (EVAR).
Methods
We retrospectively reviewed data from all patients who underwent EVAR with more than 12 months of follow-up at our center between January 2022 and September 2022. The study included 64 patients with a mean age of 66.3 ± 13.9 years and a male-to-female ratio of 82.8%. We employed the sequential suture and plug VCDs technique as the standard practice for access closure. Technical success was defined as achieving complete hemostasis without needing bailout endovascular or surgical interventions. Access-related complications were assessed at 30 days and during the most recent follow-up computed tomography (CT) scan, with the severity graded according to the Society of Interventional Radiology (SIR) classification.
Results
The sequential suture and plug VCDs technique demonstrated a 100% success rate across the study population. The mean follow-up time from the procedure to the most recent scan was 16.1 ± 2.2 months, and the mean sheath size used was 20.5 ± 2.3 Fr. Short-term complications occurred in 4.1% of cases, comprising minor access bleeding incidents (n = 3) and pseudoaneurysm (n = 1). No long-term complications were observed during the study period, with no major complications reported. Additionally, the accessed vessels exhibited a significant increase in calcification score (1.02 ± 1.05 vs. 1.36 ± 1.08; p = 0.027) between the baseline and the last follow-up scan, while there were no significant changes in diameter.
Conclusions
The sequential suture and plug VCDs technique represents a safe method for access closure during EVAR, demonstrating low rates of short-term and long-term complications. However, further investigation through larger multi-center studies is warranted.