A Retrospective Analysis of Surgical Femoral Artery Closure Techniques: Conventional vs. Purse Suture Technique

Abstract Introduction Different techniques have been reported for the exploration and repair of femoral artery (FA) in patients who undergo minimally invasive cardiac surgery (MICS) and endovascular aortic surgery. We used a modified approach alternative to the conventional technique (group CT) since May 2013, which specifies a shorter groin incision and diamond shaped hemostatic purse sutures for arteriotomy closure without the requirement of cross-clamping (group PT) and evaluated early outcomes and the complication profiles of the two techniques for femoral access. Methods In our clinic, between May 2011 and December 2015, 503 FA cannulations were performed on 345 patients who underwent MICS (n=109; mean age:64.1±17.6; F/M:71/38), EVAR (n=158; mean age:71.3±10.2; F/M:63/95), TEVAR (n=50; mean age:65.0±15.3; F/M:15/35) and TAVI (n=28; mean age:80.8±5.9; F/M:13/15). A total number of 295 FAs were exposed via mini incision and were repaired with the PT. We compared the duration of femoral closure (FC), wound infection, vascular complications including bleeding-hematoma, thromboembolic and ischemic events, pseudoaneurysm, seroma, surgical reintervention rates, delayed hospital stay for groin complications and existence of postoperative local luminal narrowing (LLN) at intervention site over 25% for both groups. Results FC time (CT, 14.9±3,16 min; PT, 6.5±1,12 min; p