Comparison of Early Efficacy of the Percutaneous Presuture Technique with the Femoral Artery Incision Technique in Endovascular Aortic Repair under Local Anesthesia for Uncomplicated Type B Aortic Dissection

Objective. To compare the efficacy of the percutaneous presuture technique (PPST) and the femoral artery incision technique (FAIT) under local anesthesia in the treatment of endovascular aortic repair (EVAR) for patients with uncomplicated type B aortic dissection (uTBAD). Method. Two hundred and ni...

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Main Authors: Qingsong Wu, Debin Jiang, Xiaochai Lv, Jiaxin Zhang, Rongda Huang, Zhihuang Qiu, Liangwan Chen
Format: Article
Language:English
Published: Hindawi-Wiley 2022-01-01
Series:Journal of Interventional Cardiology
Online Access:http://dx.doi.org/10.1155/2022/6550759
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author Qingsong Wu
Debin Jiang
Xiaochai Lv
Jiaxin Zhang
Rongda Huang
Zhihuang Qiu
Liangwan Chen
author_facet Qingsong Wu
Debin Jiang
Xiaochai Lv
Jiaxin Zhang
Rongda Huang
Zhihuang Qiu
Liangwan Chen
author_sort Qingsong Wu
collection DOAJ
description Objective. To compare the efficacy of the percutaneous presuture technique (PPST) and the femoral artery incision technique (FAIT) under local anesthesia in the treatment of endovascular aortic repair (EVAR) for patients with uncomplicated type B aortic dissection (uTBAD). Method. Two hundred and ninety-five patients diagnosed with uTBAD who underwent EVAR under local anesthesia from June 2017 to December 2021 were consecutively and randomly selected for retrospective analysis. The PPST was performed in 178 cases and the FAIT was performed in 117 cases. The clinical characteristics and surgical and postoperative data from the two groups were analyzed. Results. There were no significant differences in clinical characteristics between the two groups (p>0.05). The operative time of the PPST group was significantly shorter than that of the FAIT group (46 (33, 58) versus 72 (67.5, 78.0) minutes, p<0.001), as was the operative approach procedure time (6 (4.5, 9.0) versus 38 (36.5, 43.5) minutes, p<0.001), and length of postoperative hospital stay (5.19 ± 2.26 versus 8.33 ± 3.76 days, p<0.001). There were fewer postoperative approach-related procedural complications in the PPST group than in the FAIT group (2 versus 12, p<0.001); similarly, the average frequency of postoperative wound disinfection was significantly lower in the PPST group (1.08 ± 0.39 versus 3.31 ± 0.91 times, p<0.05). Obesity was identified as an independent risk factor for postoperative approach-related procedural complications (OR, 22.26; 95% CI, 4.74–104.49; p<0.001). Conclusions. The PPST has comparable safety and efficacy to the FAIT in EVAR under local anesthesia. It can shorten the length of hospital stay, reduce operation time, lower the risk of wound-related complications, reduce the frequency of postoperative wound disinfection, and hasten postoperative recovery. It can therefore be used as a first-line surgical technique in EVAR of uTBAD under local anesthesia, especially in obese patients.
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spelling doaj.art-063b60af20264debbff989c07557fd4e2022-12-22T04:04:40ZengHindawi-WileyJournal of Interventional Cardiology1540-81832022-01-01202210.1155/2022/6550759Comparison of Early Efficacy of the Percutaneous Presuture Technique with the Femoral Artery Incision Technique in Endovascular Aortic Repair under Local Anesthesia for Uncomplicated Type B Aortic DissectionQingsong Wu0Debin Jiang1Xiaochai Lv2Jiaxin Zhang3Rongda Huang4Zhihuang Qiu5Liangwan Chen6Department of Cardiovascular SurgeryDepartment of Cardiovascular SurgeryDepartment of Cardiovascular SurgeryDepartment of Cardiovascular SurgeryDepartment of Cardiovascular SurgeryDepartment of Cardiovascular SurgeryDepartment of Cardiovascular SurgeryObjective. To compare the efficacy of the percutaneous presuture technique (PPST) and the femoral artery incision technique (FAIT) under local anesthesia in the treatment of endovascular aortic repair (EVAR) for patients with uncomplicated type B aortic dissection (uTBAD). Method. Two hundred and ninety-five patients diagnosed with uTBAD who underwent EVAR under local anesthesia from June 2017 to December 2021 were consecutively and randomly selected for retrospective analysis. The PPST was performed in 178 cases and the FAIT was performed in 117 cases. The clinical characteristics and surgical and postoperative data from the two groups were analyzed. Results. There were no significant differences in clinical characteristics between the two groups (p>0.05). The operative time of the PPST group was significantly shorter than that of the FAIT group (46 (33, 58) versus 72 (67.5, 78.0) minutes, p<0.001), as was the operative approach procedure time (6 (4.5, 9.0) versus 38 (36.5, 43.5) minutes, p<0.001), and length of postoperative hospital stay (5.19 ± 2.26 versus 8.33 ± 3.76 days, p<0.001). There were fewer postoperative approach-related procedural complications in the PPST group than in the FAIT group (2 versus 12, p<0.001); similarly, the average frequency of postoperative wound disinfection was significantly lower in the PPST group (1.08 ± 0.39 versus 3.31 ± 0.91 times, p<0.05). Obesity was identified as an independent risk factor for postoperative approach-related procedural complications (OR, 22.26; 95% CI, 4.74–104.49; p<0.001). Conclusions. The PPST has comparable safety and efficacy to the FAIT in EVAR under local anesthesia. It can shorten the length of hospital stay, reduce operation time, lower the risk of wound-related complications, reduce the frequency of postoperative wound disinfection, and hasten postoperative recovery. It can therefore be used as a first-line surgical technique in EVAR of uTBAD under local anesthesia, especially in obese patients.http://dx.doi.org/10.1155/2022/6550759
spellingShingle Qingsong Wu
Debin Jiang
Xiaochai Lv
Jiaxin Zhang
Rongda Huang
Zhihuang Qiu
Liangwan Chen
Comparison of Early Efficacy of the Percutaneous Presuture Technique with the Femoral Artery Incision Technique in Endovascular Aortic Repair under Local Anesthesia for Uncomplicated Type B Aortic Dissection
Journal of Interventional Cardiology
title Comparison of Early Efficacy of the Percutaneous Presuture Technique with the Femoral Artery Incision Technique in Endovascular Aortic Repair under Local Anesthesia for Uncomplicated Type B Aortic Dissection
title_full Comparison of Early Efficacy of the Percutaneous Presuture Technique with the Femoral Artery Incision Technique in Endovascular Aortic Repair under Local Anesthesia for Uncomplicated Type B Aortic Dissection
title_fullStr Comparison of Early Efficacy of the Percutaneous Presuture Technique with the Femoral Artery Incision Technique in Endovascular Aortic Repair under Local Anesthesia for Uncomplicated Type B Aortic Dissection
title_full_unstemmed Comparison of Early Efficacy of the Percutaneous Presuture Technique with the Femoral Artery Incision Technique in Endovascular Aortic Repair under Local Anesthesia for Uncomplicated Type B Aortic Dissection
title_short Comparison of Early Efficacy of the Percutaneous Presuture Technique with the Femoral Artery Incision Technique in Endovascular Aortic Repair under Local Anesthesia for Uncomplicated Type B Aortic Dissection
title_sort comparison of early efficacy of the percutaneous presuture technique with the femoral artery incision technique in endovascular aortic repair under local anesthesia for uncomplicated type b aortic dissection
url http://dx.doi.org/10.1155/2022/6550759
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