Totally percutaneous access using perclose proglide for endovascular treatment of aortic diseases. Moreover, the percutaneous approach allows for procedures to be performed under local anesthesia, while providing a low risk for accessrelated. Perclose device with the standard technique and larger sheaths up to 21 french using two perclose devices with the perclose technique. Perclose proglide suturemediated closure system failure. Guide to vascular closure perclose proglide suture.
The perclose has a distal flexible sheath that is overmolded directly onto the proximal rigid guide. If excessive resistance in advancing the perclose proglide smc device is encountered, withdraw the device over a 0. However, the precaution, preparation and procedure techniques have not been well described in the literature. Cumulative sum analysis of the learning curve for the. Closure devices are commonly used in neurointerventional procedures to achieve groin hemostasis. We report a series of 12 patients in whom total percutaneous cpb was successfully established using a.
Originally, the prostar and techstar featured needles that were deployed within the arterial lumen and directed towards the skin through the arterial wall. Perclose synonyms, perclose pronunciation, perclose translation, english dictionary definition of perclose. The operator did not have any prior experience with the preclosure technique in pevar or ptevar before this study. 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. Remove the perclose proglide sheath before tightening the suture. The 30 prolene of the device was gently repaired in moist gauze without tension. A perclose proglide device was obtained for simulating closure of the vessel.
An alternative technique to achieve haemostasis during pevar. 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. Advantages of vascular closure device over manual compression include patient comfort, early. 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. Pdf 24h and 30 day outcome of perclose proglide suture. T1 use of the perclose proglide device with the 9 french merci retrieval system.
Perclose closure device breakage and embolization during. Two surgeons performed the proglide closures in all patients. Perclose proglide suturemediated closure system abbott. 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. Perclose proglide suturemediated closure system deployment steps 2011 abbott. 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. Major and minor complications, procedure success, device failure were predefined. We used the perclose proglide for safe and rapid exchange of the 0. The perclose proglide suturemediated closure system is composed of a plunger, handle, guidewire, and sheath. 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. 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.
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. For sheath sizes greater than 8f, at least two devices and the preclose technique are required. Predictors and treatments of progliderelated complications in. Heparin was reversed half dose and manual compression was maintained for at. A randomized trial comparing compression, perclose proglide.
Percutaneous femoral access is the preferred access route for transcatheter aortic valve replacement tavr. 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. Purpose to investigate the predictors and treatment of the 6fr perclose proglide related complications prc in percutaneous endovascular aortic repair pevar. 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. Total percutaneous endovascular repair of abdominal aortic. We describe the use of the proglide device with 9f sheaths in acute stroke treatment using the merci retrieval. Advantages of vascular closure device over manual compression include patient comfort, early mobilisation and discharge. Percutaneous removal using perclose proglide closure devices. Proglide tops prostar xl for accesssite closure after. Abbott laboratories, chicago, il, usa closure device is becoming increasingly prevalent during percutaneous endovascular aortic repair evar and transcatheter aortic valve implantation tavi. After the insertion of the second vascular closure device, a 7 f short sheath was inserted to avoid bleeding. Perclose proglide vascular close device surgery video.
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. This junction of sheath and guide may be a weak point. The first perclose proglide was positioned at 11 oclock and the second one at 1 oclock. Pdf totally percutaneous access using perclose proglide. Review of vascular closure devices cath lab digest. The study included all patients who underwent vaecmo and in whom perclose proglide was deployed to achieve hemostasis during closure of the cfa site. Procedure success was defined as effective functioning of the two devices. Instead of open arteriotomy repair, successful percutaneous perclose proglide postclose technique has been reported for venoarterial extracorporeal membrane oxygenation vaecmo decannulation.
The perclose proglide 6f smc system is designed for use in 5f to 21f access sites. Comparative data of single versus double proglide vascular. Use of a perclose proglide device for percutaneous endovascular aortic aneurysm repair in a general hospital experience article pdf available in discovery medicine 22121. These devices are particularly useful in procedures requiring anticoagulation and larger catheters.
Preclose percutaneous endurant endografting with the. Accidental pressure applied at this weak point in any perclose device during deployment can cause breakage. 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. Establishment of a highly standardized and safe decannulation technique based on. 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. Bleeding was addressed by manual compression in 4 cases. Patients were excluded if 24hour and 30day followup data regarding the access sites and other clinical outcomes were not available. Mar 14, 2006 closure devices are commonly used in neurointerventional procedures to achieve groin hemostasis. Purpose to investigate the predictors and treatment of the 6fr perclose progliderelated complications prc in percutaneous endovascular aortic repair pevar. Use of the perclose proglide device with the 9 french merci. Pdf use of a perclose proglide device for percutaneous. The traditional method to deploy a proglide suturemediated closure device during largebore vessel closure involves placing a long 0. Oct 26, 2019 all pevar procedures were performed with the perclose proglide abbott vascular device by an experienced 10 years vascular surgeon.
The tip of the broken perclose was caught with the snare and pulled out. To investigate the predictors and treatment of the 6fr perclose progliderelated complications prc in percutaneous endovascular aortic. The strands were left outside of the body and tagged with a small clamp. With a onesizefitsall design, the proglide reduces inventory and saves money. The suturemediated perclose proglide device is intended for use with 5f to 8f sheaths. Time to ambulation was shorter with angioseal vip than with perclose proglide 261 vs. Adjunctive technique for the use of proglide vascular closure. Tavi using single versus double perclose proglide devices. This system has the broadest arterial and venous indication. The respective conditions treated via these procedures, abdominal aortic aneurysm and aortic valve stenosis, share risk factors.
The perclose is a stitch that is introduced through the femoral puncture site to close the femoral arteryvein and stop the bleeding. This video describe the skills to use the perclose proglide in safe mode during the aortic procedures. A stopped pilot study of the proglide closure device after. Perclose proglide suturemediated closure system provides the security of suture for vascular closure of 5f 21f femoral artery access sites.
Perclose definition of perclose by the free dictionary. We describe an adjunctive technique for the use of the proglide vascular closure device to improve hemostasis. Abbotts perclose proglide smc system also offers the following benefits. 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. Abbott vascular perclose proglide suturemediated closure smc. How supplied the perclose proglide smc device and accessories are provided sterile and nonpyrogenic in unopened, undamaged packages. Perclose proglide suturemediated closure smc system delivers a secure, nonmasking percutaneous suture to the access site that promotes primary healing 1 and has no reaccess restrictions. Reduced time to hemostasis, ambulation and discharge compared to manual. Total percutaneous endovascular repair of abdominal aortic aneurysms using perclose proglide closure devices. The perclose proglide smc system is used without or, if required, with adjunctive manual compression. 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. The pdac approved proglide cervical collar offers a complete solution for individuals with cervical injuries that require a collar for extended wear.
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. Possible mechanism for common femoral artery occlusion with. The device is designed to deliver a single suture stitch to close the puncture sites. Totally percutaneous access using perclose proglide for. Mar 08, 2019 accessgudid perclose proglide 08717648089 perclose proglide 6f suturemedicated closure system.
The preclose technique with 6fr perclose proglide devices for pevar. Predictors and treatments of progliderelated complications. How supplied the perclose proglide smc device and accessories are provided sterile and nonpyrogenic in. Au sy, chan ks, fong km, leung pw, ng wy, leung kh. The perclose proglide abbott vascular, santa clara, calif is indicated for the closure of 5f to 21f femoral artery access sites. However, the precaution, preparation and procedure techniques. New wireretained method to performing the preclose. Feasibility and safety of total percutaneous closure of. The unique chin height adjustment technology 12 levels allows for customized fitting with a simple turn of the knob. Comparison of complication and success rates of proglide. Access site management with vascular closure devices for. The utilization of single versus double perclose devices for. Abbott, 12673, abbott perclose proglide suturemediated. Pma monthly approvals from 212018 to 2282018 original.
Total percutaneous cardiopulmonary bypass with perclose proglide. Percutaneous decannulation instead of surgical removal for w. This study aimed to assess the feasibility of percutaneous arterial access site closure after percutaneous transfemoral transcatheter aortic valve implantation tf. Case report a 76yearold male presented with shortness of breath and congestive heart failure class iv. The perclose proglide smc system is depicted in figure 2. Perclose proglide 6f suturemediated closure smc system.
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