Vascular access complications in endovascular procedures with large sheaths

Anne Lejay, Thibault Caspar, Mickael Ohana, Charline Delay, Elie Girsowicz, Patrick Ohlmann, Fabien Thaveau, Bernard Geny, Yannick Georg, Nabil Chakfe

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

Endovascular procedures, such as transcatheter aortic valve implantation (TAVT), thoracic endovascular aortic repair (TEVAR), and endo- vascular abdominal aortic repair (EVAR) have been established as promising less invasive therapeutic options. However, despite continuous advances and device improvements, the use of large-sheaths still remains an important challenge, since significant coexisting arterial disease may be encountered in patients undergoing such procedur es. Identification of coexisting arterial diseases by optimal preoper ative imaging assessment is essential to anticipate these difficulties and avoid the complications by using adequate access options. Should a vascular complication such as iliac rupture occur, vascular interventionists must be aware of salvage procedures to control and treat major complications, such as maintaining wire access across the rupture for occlusion balloon placement and vessel control, while disruption is addressed either through an endovascular or an open approach. The aims of this review are to describe how to prevent vascular complications by optimal preoper ative imaging assessment, to detail intraoperative options available for addressing difficult access issues and to discuss how to manage intraoperative major vascular complications.

Original languageEnglish (US)
Pages (from-to)311-321
Number of pages11
JournalJournal of Cardiovascular Surgery
Volume57
Issue number2
StatePublished - Apr 2016

Keywords

  • Abdominal
  • Aorta
  • Aorta
  • Endovascular surgical procedure
  • Postoperative complications
  • Surgery
  • Surgery
  • Thoracic
  • Transcatheter aortic valve replacement
  • Vascular access devices
  • Vascular surgical procedures

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

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