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Standard access for EVAR in many centers is done via bilateral open surgical cutdown of the common femoral artery in the groin. Although a minor surgical procedure, this cutdown is inherently associated with a low degree of complications, such as groin hematoma, lymphocele, intimal dissection, femoral nerve injury, delayed wound healing, and infection. The induced scar tissue can hamper future access to the groin.

By lifting EVAR to a percutaneous level, the degree of invasiveness of AAA treatment can be further reduced. Percutaneous endovascular aortic aneurysm repair (PEVAR) using the preclose suture technique via femoral artery access has become more popular in recent years. Few commercially available devices are reported in the literature for percutaneous closure of large-sheath access via the common femoral artery (CFA) including Perclose ProGlide and Prostar XL (Abbott Vascular). Technical success rates of up to 98% are reported, with improvement over time.

The recorded cases below, additionnally to specific lectures and interviews, expose the access and closure technique with the suture-based Perclose ProGlide device.


Contributors

Matteo Barbante, Rome, Italy
Carlo Coscarella, Rome, Italy
Ciro Ferrer, Rome, Italy
Giovanni Pratesi, Genova, Italy

PEVAR tips and ticks

Proglide presentation, advantages (especially downsizing technic)

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