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Risk Factors for Access-Related Adverse Events Related to the Preclose Technique in Thoracic Endovascular Aortic Repair.

PURPOSE: To analyze the risk factors for access-related adverse events (AEs) of the preclose technique in thoracic endovascular aortic repair (TEVAR).

MATERIALS AND METHODS: Ninety-one patients with type Stanford B aortic dissection underwent preclose technique in TEVAR between January 2013 to December 2021 were included. According to the occurrence of access-related AEs, the patients were divided into two groups: the with AE group and the without AE group. Age, sex, combined diseases, body mass index, skin depth, femoral artery diameter, access calcification, ilio-femoral artery tortuosity, and sheath size were recorded for risk factor analysis. Sheath to femoral artery ratio (SFAR), the ratio of the femoral artery inner diameter (mm) to the sheath outer diameter (mm), was also for analysis.

RESULTS: SFAR was identified as an independent risk factor of AEs using multivariable logistics analysis (odds ratio: 251.748, 95% confidence interval: 7.004 - 9048.534, P = 0.002). The cut-off value of SFAR was 0.85, and was related to a higher incidence of access-related AE (5.2% vs 33.3%, P = 0.001), especially to a higher stenosis rate (0.0% vs 21.2%, P = 0.001).

CONCLUSIONS: SFAR is an independent risk factor for access-related AE of preclose in TEVAR with a cut-off value of 0.85. SFAR could be a new criterion for preoperative access evaluation in high-risk patients, which may be able to detect and treat access-related AEs at the early stage.

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