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Journal of Peking University (Health Sciences) ›› 2026, Vol. 58 ›› Issue (2): 388-392. doi: 10.19723/j.issn.1671-167X.2026.02.025

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Outcomes of suture-mediated vascular closure device in the closure of left brachial artery access site after thoracic endovascular aortic repair

Weihao LI, Xuemin ZHANG*(), Wei LI, Tao ZHANG, Xiaoming ZHANG   

  1. Department of Vascular Surgery, Peking University People's Hospital, Beijing 100044, China
  • Received:2023-09-06 Online:2026-04-18 Published:2025-07-25
  • Contact: Xuemin ZHANG
  • Supported by:
    the Beijing Xicheng District Science and Technology Special Projects(XCSTS-SD2022-05)

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Abstract:

Objective: To evaluate the feasibility and safety of the suture-mediated vascular closure device in the closure of the left brachial artery access site after thoracic endovascular aortic repair (TEVAR). Methods: Data from 91 patients receiving TEVAR with left brachial artery puncture from January 2021 to May 2023 were retrospectively collected and analyzed. In 27 cases whose brachial artery was over 5 mm, a suture-mediate vascular closure device (Perclose ProGlide, Abbott) was used to deal with the left brachial artery access, and in the other 64 cases with brachial artery < 5 mm, manual compression was used. The primary outcomes were the incidence of perioperative access-related complications and long-term outcomes. Results: In the suture-mediate device group, the access-site compression time was significantly reduced than that in the manual compression group (P < 0.001). The proportion of discomforts, such as numbness, pain, and swelling of the compression-related limbs was significantly lower than that in the compression-alone group (3.70% vs. 42.19%, P < 0.001). One case with brachial artery access-related complications occurred in the suture-mediate device group during hospitalization, which was acute brachial artery occlusion and required reinterventions. In the manual compression group, 4 cases of brachial artery puncture point complications occurred during hospitalization, including 3 cases of pure hematoma with conservative management and 1 case of pseudoaneurysm requiring reintervention. There was no significant difference in the incidence of early puncture point complications between the two groups (3.70% vs. 6.25%, P=0.625). During an average follow-up of (14±6) months, no access-related complications of the left brachial artery occurred. Conclusion: It is effective to use the suture-mediated vascular closure in the left brachial artery access site after TEVAR, and the long-term effect is satisfactory. For patients with >5 mm brachial artery, it is reasonable to use suture-mediated vascular devices to deal with brachial artery access.

Key words: Vascular closure device, Thoracic endovascular aortic repair, Brachial artery, Treatment outcome

CLC Number: 

  • R654.3

Table 1

Comparison of basic data between two groups"

Items Suture-mediate device group (n=27) Compression-alone group (n=64) Statistic P
Gender (male) 22 (81.48) 53 (82.81) >0.999a
Age/years 47.3±13.6 54.2±13.2 -2.255 0.027
BMI/(kg/m2) 24.2±3.6 26.5±5.7 -1.071 0.287
Smoking history 12 (44.44) 30 (46.88) 0.045a 0.832
Hypertension 19 (70.37) 53 (82.81) 1.779a 0.182
Diabetes 2 (7.41) 5 (7.81) >0.999a
Coronary heart disease 2 (7.41) 8 (12.50) 0.732a
Peripheral arterial disease 0 (0) 3 (4.69) 0.552a
ASA grade 0.941a
  Ⅰ 1 (3.70) 5 (7.81)
  Ⅱ 13 (48.15) 26 (40.62)
  Ⅲ 11 (40.74) 27 (42.19)
  Ⅳ 2 (7.41) 6 (9.38)

Figure 1

Suture steps for suture-mediated vascular closure device A, the diameter of brachial artery measured by angiography was 6.48 mm; B, push the vascular closure device forward gently until pulsatile blood spray appears in the observation hole, then stop the advancement and keep the device in place (pay attention to observation hole); C, complete the plunger depression and remove the device while pulling tension on the blue Prolene; D, tighten the vascular suture knot and observe the bleeding in the puncture site; E, after the suture procedure was completed, the bleeding at the puncture point stopped."

Table 2

Comparison of brachial artery compression results between the two groups"

Items Suture-mediate device group (n=27) Compression-alone group (n=64) Statistic P
Brachial artery diameter/mm 5.4±0.3 4.2±0.4 14.7 ＜0.001
Vascular sheath 0.077a
  5F 0 (0) 5 (7.81)
  6F 19 (70.37) 52 (81.25)
  7F 6 (22.22) 7 (10.94)
  8F 2 (7.41) 0 (0)
Compression time/h 6 (6, 7) 22 (20, 25) -7.537b ＜0.001b
Oppression-related discomfort 1 (3.70) 27 (42.19) ＜0.001a
Puncture point complication 1 (3.70) 4 (6.25) 0.625a
  Thrombopoiesis 1 (3.70) 0 (0)
  Hematoma/pseudoaneurysm 0 (0) 4 (6.25)
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