中文摘要：

目的总结经皮穿刺腹主动脉瘤腔内修复术(pEVAR)中应用Perclose ProGlide血管缝合器的经验,并评估该缝合器的可行性及安全性。方法回顾性分析本中心自2012年12月至2013年7月完成的57例pEVAR患者的临床资料,观察围手术期并发症发生的情况。结果 57例患者腹主动脉瘤腔内治疗的手术即刻技术成功率为100%(57/57),手术平均时间(93.5±17.8)min。ProGlide共缝合106处股动脉入路,其中缝合20F~22 F血管鞘36例次,18 F以下血管鞘70例次。血管缝合器一次成功率88.7%(94/106),二次成功率91.5%(97/106)。缝合失败导致穿刺点出血5例,其中2例行手术探查止血,3例局部压迫并加压包扎止血;入路动脉闭塞4例,均行手术探查并重新缝合。术后蓝趾综合征(垃圾脚)6例,发生率5.7%(6/106)。围手术期无死亡等严重并发症,患者均顺利出院。结论 pEVAR术中使用Perclose ProGlide缝合器安全有效,加强术者经验并挑选合适患者有助于降低手术并发症发生率。

英文摘要：

Objective To evaluate the safety and efficacy of percutaneous endovascular aneurysm repair (pEVAR) using the Perclose ProGlide closure system. Methods From December 2012 to July 2013, clinical data of 57 pEVAR cases were analyzed retrospectively, including perioperative complications and treatment. Results The technical success rate of pEVAR was 100%(57/57). The mean operating time was (93.5±17.8) min. Multiple ProGlide devices were used in a total of 106 femoral sites, including 20F~22 F access sites (n=36) and≤18F access sites (n=70). The initial technical success rate for the ProGlide closure devices was 88.7%(94/106), and the secondary technical success rate was 91.5%(97/106). ProGlide devices failed to achieve hemostasis for 5 patients. Surgical hemostasis (n=2) and local compression (n=3) were required. For 4 patients, ProGlide devices caused the stenosis or occlusion lesion in the puncture site, which were treated with surgical repair. The rate of blue toe syndrome was 5.7%(6/106). All the patients were discharged with no perioperative mortality. Conclusion Percutaneous closure technique using multiple Perclose ProGlide devices appears safe and effective in endovascular stent-graft treatment of abdominal aortic aneurysm. Local access related complications would be low in selected patients, providing that the operator has sufficient practical experience of this technique.