A clampless and atraumatic technique for surgical preclosure of peripheral arteries

Abstract

Peripheral vascular access and closure are fundamental skills in cardiovascular surgery, especially in the era of transcatheter and minimally invasive surgical techniques. Conventional arterial access via surgical cutdown typically requires vascular clamps for surgical control and primary closure. We have been utilizing a surgical preclosure technique that does not require vascular clamping. The technique utilizes 4 to 5 full-thickness Prolene sutures placed in an interrupted fashion at the site of access instead of traditional purse-string sutures. These sutures are placed prior to vascular access. The sutures are not tied down until the procedure is complete and the vascular sheath is removed. This technique allows for adequate control and closure of the peripheral access artery without the use of vascular clamps and avoids traumatic manipulation of the artery.

Keywords: Peripheral arterial access; TAVI; Transaxillary TAVI; Transcarotid TAVI; Transfemoral TAVI.