Vascular access complications in endovascular procedures with large sheaths.
Fiche publication
Date publication
avril 2016
Journal
The Journal of cardiovascular surgery
Auteurs
Membres identifiés du Cancéropôle Est :
Pr OHANA Mickaël, Pr GENY Bernard
Tous les auteurs :
Lejay A, Caspar T, Ohana M, Delay C, Girsowicz E, Ohlmann P, Thaveau F, Geny B, Georg Y, Chakfe N
Lien Pubmed
Résumé
Endovascular procedures, such as transcatheter aortic valve implantation (TAVI), thoracic endovascular aortic repair (TEVAR), and endovascular 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 procedures. Identification of coexisting arterial diseases by optimal preoperative 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 preoperative imaging assessment, to detail intraoperative options available for addressing difficult access issues and to discuss how to manage intraoperative major vascular complications.
Mots clés
Aortic Aneurysm, surgery, Blood Vessel Prosthesis Implantation, adverse effects, Endovascular Procedures, adverse effects, Heart Valve Diseases, surgery, Humans, Postoperative Complications
Référence
J Cardiovasc Surg (Torino). 2016 Apr;57(2):311-21