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Int J Angiol 2018; 27(01): 013-022
DOI: 10.1055/s-0037-1620241
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Fascia Suture Technique and Suture-mediated Closure Devices: Systematic Review

Georgios Karaolanis
1   Vascular Unit, First Department of Surgery, National and Kapodistrian University of Athens, “Laiko” General Hospital, Athens, Greece
,
Ioannis D. Kostakis
2   Second Department of Propedeutic Surgery, National and Kapodistrian University of Athens, “Laiko” General Hospital, Athens, Greece
,
Demetrios Moris
1   Vascular Unit, First Department of Surgery, National and Kapodistrian University of Athens, “Laiko” General Hospital, Athens, Greece
,
Viktoria-Varvara Palla
1   Vascular Unit, First Department of Surgery, National and Kapodistrian University of Athens, “Laiko” General Hospital, Athens, Greece
,
Konstantinos G. Moulakakis
3   Department of Vascular Surgery, Athens University Medical School, Attikon University Hospital, Athens, Greece
› Author Affiliations
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Publication History

Publication Date:
22 January 2018 (online)

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Abstract

Background The aim of the present study is to review the available data on suture-mediated closure devices (SMCDs) and fascia suture technique (FST), which are alternatives for minimizing the invasiveness of percutaneous endovascular aortic aneurysm repair (p-EVAR) and reduce the complications related to groin dissections.

Methods The Medline, ClinicalTrials.gov, and Cochrane library – Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched for publications regarding SMCD and FST between January 1999 and December 2016.

Results We review 37 original articles, 30 referring to SMCDs (Prostar XL and Proglide), which included 3,992 patients, and 6 articles referring to FST, which include 426 patients. The two techniques are compared only in one article (100 patients). The two types of SMCDs were Prostar and Proglide. In most studies on SMCDs, the reported technical success rates were between 89 and 100%, but the complication rates varied greatly between 0 and 25%. Concerning FST, the technical success rates were also high, ranging between 87 and 99%. However, intraoperative complication rates ranged between 1.2 and 13%, whereas postoperative complication rates varied from 0.9 to 6.2% for the short-term and from 1.9 to 13.6% for the long-term.

Conclusions SMCDs and FST seem to be effective and simple methods for closing common femoral artery (CFA) punctures after p-EVAR. FST can reduce the access closure time and the procedural costs with a quite short learning curve, whereas it can work as a bailout procedure for failed SMCDs suture. The few failures of the SMCDs and FST that may occur due to bleeding or occlusion can easily be managed.

Keywords

suture-mediated closure devices - Prostar XL - Proglide system - fascia suture technique - percutaneous endovascular aortic aneurysm repair - femoral access - complications
 

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