1040 Impact of Common Femoral Artery Calcification on the Comparative Efficacy of Vascular Closure Device Deployments Following Large Bore Vascular Access
A Hakeem, Z Khoker, M Najem, A Chaudhuri- Surgery
Abstract
Introduction
The suture-mediated ProGlide and more recently, the plug-based MANTA are commonly used vascular closure devices (VCDs) for large-bore vascular access haemostasis, though both devices operate differently. The site and extent of the common femoral artery (CFA) calcification are significant determinants of the choice of VCD. Anterior calcification may hamper ProGlide deployments, while posterior calcification may represent a similar consideration for the MANTA.
Method
A retrospective analysis of procedures with large-bore CFA access from 2017 to 2022 was undertaken. The access sites are grouped as Group A (Proglide) and Group B (MANTA). Calcification graded as (0 = none, 1 = Anterior, 2 = Posterior and 3 = Anterior & Posterior) on preoperative CTA along 10mm segments with 0.625mm slice thickness. Minitabv21 was used for Statistical analysis, particularly analysing the correlation of calcification to VCD deployment success rates.
Results
We assessed 207 endovascular procedures with 374 large-bore accesses (243 Group A, 127 Group B). The mean age was 74.9±8 (183 males), the average BMI was 28±5.8 (44 diabetics), and 180 (86.9%) were smokers. Grade 1 Calcification was 1.8%, Grade 2, 49% (120 Group A, 63 Group B) and Grade 2, 14.3% (31 Group A, 22 Group B). Successful deployment was achieved in 91% (337 groins, p = 0.86). The correlation of calcification with successful deployment was not significant p = 0.33.
Conclusions
Posterior calcification was more common in both groups. The site of calcification did not impact the efficacy of the closure device. All our percutaneous accesses were ultrasound-guided, we concluded it can improve the effectiveness of VCD, avoiding calcification.