Abbott laboratories, chicago, il, usa closure device is becoming increasingly prevalent during percutaneous endovascular aortic repair evar and transcatheter aortic valve implantation tavi. However, the precaution, preparation and procedure techniques have not been well described in the literature. Perclose proglide suturemediated closure system abbott. An alternative technique to achieve haemostasis during pevar. The removal of arterial cannulas using a perclose device abbott vascular, clonmel, tipperary, ireland has not been reported in patients undergoing venoarterial extracorporeal membrane oxygenation ecmo. Perclose proglide vascular close device surgery video. Instead of open arteriotomy repair, successful percutaneous perclose proglide postclose technique has been reported for venoarterial extracorporeal membrane oxygenation vaecmo decannulation. The perclose proglide smc system is depicted in figure 2. The perclose proglide smc system is used without or, if required, with adjunctive manual compression. Percutaneous removal using perclose proglide closure devices.
The traditional method to deploy a proglide suturemediated closure device during largebore vessel closure involves placing a long 0. Perclose device with the standard technique and larger sheaths up to 21 french using two perclose devices with the perclose technique. Predictors and treatments of progliderelated complications in. Originally, the prostar and techstar featured needles that were deployed within the arterial lumen and directed towards the skin through the arterial wall. All consecutive patients with perclose proglide smc deployment done by a single operator for achieving access site haemostasis where 24 h and 30 day postprocedure data were available were included. Two surgeons performed the proglide closures in all patients. Total percutaneous cardiopulmonary bypass with perclose proglide. The unique chin height adjustment technology 12 levels allows for customized fitting with a simple turn of the knob. The respective conditions treated via these procedures, abdominal aortic aneurysm and aortic valve stenosis, share risk factors. Major and minor complications, procedure success, device failure were predefined. Bleeding was addressed by manual compression in 4 cases. Percutaneous decannulation instead of surgical removal for w. Percutaneous femoral access is the preferred access route for transcatheter aortic valve replacement tavr.
The pdac approved proglide cervical collar offers a complete solution for individuals with cervical injuries that require a collar for extended wear. The operator did not have any prior experience with the preclosure technique in pevar or ptevar before this study. Purpose to investigate the predictors and treatment of the 6fr perclose proglide related complications prc in percutaneous endovascular aortic repair pevar. Perclose closure device breakage and embolization during.
If excessive resistance in advancing the perclose proglide smc device is encountered, withdraw the device over a 0. After the insertion of the second vascular closure device, a 7 f short sheath was inserted to avoid bleeding. The first perclose proglide was positioned at 11 oclock and the second one at 1 oclock. The majority of experienced tavr centers use two 6f perclose proglide devices to close the primary vascular access site, deployed prior to upsizing sheath size with closure completed at the end of the case the preclose approach.
Perclose synonyms, perclose pronunciation, perclose translation, english dictionary definition of perclose. Methods we retrospectively analyzed the prc after pevar for the treatment of aortic aneurysm or dissection in our center from december 2012 to november 20. Advantages of vascular closure device over manual compression include patient comfort, early. We report a series of 12 patients in whom total percutaneous cpb was successfully established using a. Heparin was reversed half dose and manual compression was maintained for at. We investigated the procedural outcomes and complications of percutaneous device closure vs surgical repair for hemostatic control of the arterial access site in weaning from venoarterial ecmo. However, the precaution, preparation and procedure techniques. Perclose proglide smc system delivers a secure, nonmasking percutaneous suture to the access site that promotes primary healing 3 and has no reaccess restrictions. Perclose abbott vascular offers suturemediated vcds that have evolved from the prostar in 1994, to the techstar, to the closer, to the perclose at, to the proglide. Oct 27, 2009 in the randomized trial comparing compression, perclose proglide and angioseal vasoactive intestinal peptide vip for arterial closure after pci trial, there was a significant higher risk of vcd failure with suturebased device compared with collagen plugbased device 15. These devices are particularly useful in procedures requiring anticoagulation and larger catheters. We used the perclose proglide for safe and rapid exchange of the 0. The perclose is a stitch that is introduced through the femoral puncture site to close the femoral arteryvein and stop the bleeding.
For sheath sizes greater than 8f, at least two devices and the preclose technique are required. Abbotts perclose proglide smc system also offers the following benefits. Use of a perclose proglide device for percutaneous endovascular aortic aneurysm repair in a general hospital experience article pdf available in discovery medicine 22121. The 30 prolene of the device was gently repaired in moist gauze without tension.
This junction of sheath and guide may be a weak point. How supplied the perclose proglide smc device and accessories are provided sterile and nonpyrogenic in. The perclose proglide suturemediated closure system abbott vascular, redwood city, ca, usa could be an attractive alternative for brachial artery closure based on use of the precursor 6f perclose device abbott vascular devices after coronary interventions in two small series. Cumulative sum analysis of the learning curve for the. P perclose proglide in preclosing 14fr to 20fr access sites for endurant endografting in the treatment of asymptomatic infrarenal aortic aneurysms is feasible and effective. We describe an adjunctive technique for the use of the proglide vascular closure device to improve hemostasis. Proglide tops prostar xl for accesssite closure after.
To investigate the predictors and treatment of the 6fr perclose progliderelated complications prc in percutaneous endovascular aortic. Comparison of complication and success rates of proglide. Pdf use of a perclose proglide device for percutaneous. We describe the use of the proglide device with 9f sheaths in acute stroke treatment using the merci retrieval. To meet this challenge, we have established a highly standardized and safe decannulation technique based on the perclose proglide closure system abbott vascular, lake bluff, il.
Totally percutaneous access using perclose proglide for endovascular treatment of aortic diseases. Use of the perclose proglide device with the 9 french merci. The strands were left outside of the body and tagged with a small clamp. The utilization of single versus double perclose devices for. Total percutaneous endovascular repair of abdominal aortic. From special incentive programs and sales to the newest products, the amd newsletter is a great way to keep tabs on everything thats important to you. Au sy, chan ks, fong km, leung pw, ng wy, leung kh. Case report a 76yearold male presented with shortness of breath and congestive heart failure class iv. Predictors and treatments of progliderelated complications.
Possible mechanism for common femoral artery occlusion with. Totally percutaneous endovascular aneurysm repair pevar with an adjunctive preclose technique perclose proglide is safe and effective, with minimal accessrelated complications, and it is noninferior to standard open femoral exposure, according to results of a randomised trial published in the journal of vascular surgery. Perclose proglide smc is a safe and effective method to. The study included all patients who underwent vaecmo and in whom perclose proglide was deployed to achieve hemostasis during closure of the cfa site. Review of vascular closure devices cath lab digest. Preclose percutaneous endurant endografting with the. Adjunctive technique for the use of proglide vascular closure.
T1 use of the perclose proglide device with the 9 french merci retrieval system. Comparative data of single versus double proglide vascular. A stopped pilot study of the proglide closure device after. Pdf 24h and 30 day outcome of perclose proglide suture. A perclose proglide device was obtained for simulating closure of the vessel. After routine use of the device, a hollow tube cut from the injection port of an introducer sheath is placed over the free tails of suture. Purpose to investigate the predictors and treatment of the 6fr perclose progliderelated complications prc in percutaneous endovascular aortic repair pevar. Abbott perclose proglide suturemediated closure system.
Perclose proglide suturemediated closure system failure. Moreover, the percutaneous approach allows for procedures to be performed under local anesthesia, while providing a low risk for accessrelated. Use of the perclose proglide suturemediated closure strategy to achieve vascular accesssite hemostasis after transfemoral tavr results in fewer major vascular complications than does deployment of the prostar xl percutaneous surgical closure system, according to an observational study published online august 27, 2015, ahead of print in the. Pdf totally percutaneous access using perclose proglide. How supplied the perclose proglide smc device and accessories are provided sterile and nonpyrogenic in unopened, undamaged packages. Guide to vascular closure perclose proglide suture.
Case 1 a 65yearold male with a history of peripheral arterial disease pad, diabetes mellitus, and coronary artery disease cad, status post bypass grafting presented to vascular surgery with foot pain after peripheral intervention. This video describe the skills to use the perclose proglide in safe mode during the aortic procedures. Accidental pressure applied at this weak point in any perclose device during deployment can cause breakage. Establishment of a highly standardized and safe decannulation technique based on.
Remove the perclose proglide sheath before tightening the suture. The perclose has a distal flexible sheath that is overmolded directly onto the proximal rigid guide. The perclose proglide 6f smc system is designed for use in 5f to 21f access sites. Pevar using the perclose proglide in preclosing 14fr to 20fr access sites for endurant endografting in the treatment of asymptomatic infrarenal aortic aneurysms is feasible and effective. Procedure success was defined as effective functioning of the two devices. Perclose proglide suturemediated closure system deployment steps 2011 abbott. Perclose proglide 6f suturemediated closure smc system. Pma monthly approvals from 212018 to 2282018 original.
Perclose definition of perclose by the free dictionary. The tip of the broken perclose was caught with the snare and pulled out. The device is designed to deliver a single suture stitch to close the puncture sites. The preclose technique with 6fr perclose proglide devices for pevar. The perclose proglide suturemediated closure system is composed of a plunger, handle, guidewire, and sheath. Oct 26, 2019 all pevar procedures were performed with the perclose proglide abbott vascular device by an experienced 10 years vascular surgeon. This system has the broadest arterial and venous indication. New wireretained method to performing the preclose. A randomized trial comparing compression, perclose proglide.
With a onesizefitsall design, the proglide reduces inventory and saves money. Closure devices are commonly used in neurointerventional procedures to achieve groin hemostasis. Access site management with vascular closure devices for. Mar 14, 2006 closure devices are commonly used in neurointerventional procedures to achieve groin hemostasis. Tavi using single versus double perclose proglide devices. The suturemediated perclose proglide device is intended for use with 5f to 8f sheaths. The perclose proglide abbott vascular, santa clara, calif is indicated for the closure of 5f to 21f femoral artery access sites.
Perclose proglide suturemediated closure system provides the security of suture for vascular closure of 5f 21f femoral artery access sites. Time to ambulation was shorter with angioseal vip than with perclose proglide 261 vs. This study aimed to assess the feasibility of percutaneous arterial access site closure after percutaneous transfemoral transcatheter aortic valve implantation tf. Totally percutaneous access using perclose proglide for. Reduced time to hemostasis, ambulation and discharge compared to manual. Abbott vascular perclose proglide suturemediated closure smc.
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