Journal of Vascular Surgery Cases and Innovative Techniques (Sep 2023)

Area reduction of perforation with a small-size sheath technique for iatrogenic femoral artery pseudoaneurysm with a large perforation

  • Ryohei Maeno, MD,
  • Ryosuke Taniguchi, MD, PhD,
  • Masamitsu Suhara, MD, PhD,
  • Yasuaki Mochizuki, MD, PhD,
  • Toshio Takayama, MD, PhD,
  • Katsuyuki Hoshina, MD, PhD

Journal volume & issue
Vol. 9, no. 3
p. 101235

Abstract

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Open surgery for femoral artery pseudoaneurysms is invasive, and complications can be detrimental. Several cases of treatment of iatrogenic femoral artery pseudoaneurysms using percutaneous suture-mediated closure devices have been reported. However, it is difficult to properly deploy the foot of the device to the arterial wall when the perforation area is large. We developed a technique using a double guidewire to partially occupy the perforation with a small-size sheath, which reduces the area of the perforation. This AREPAS (area reduction of perforation with a small-sized sheath) technique might allow for minimally invasive closure of perforations even in patients with large perforation areas.

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