# Feasibility of a modified hybrid glubran-supported single-proglide technique for access closure during endovascular aneurysm repair

## TL;DR

This study shows a new technique for closing large blood vessel access after aneurysm repair is fully successful in initial trials.

## Contribution

A hybrid Glubran-supported single-Proglide technique is introduced and shown to be 100% technically successful for large bore access closure.

## Key findings

- The technique achieved 100% success rate with no major vascular complications.
- Only one access site infection occurred, which was treated without surgery.
- No 30-day mortality was observed in the study population.

## Abstract

This study aimed to evaluate the feasibility of a hybrid Glubran-supported single-Proglide technique for large bore femoral access closure during percutaneous access endovascular aneurysm repair (EVAR).

A retrospective cohort study was performed for all percutaneous EVARs at our center from January 2023 to June 2023. All patients received the hybrid Glubran-supported single-Proglide technique involving a mixture of surgical glue and Lipiodol injection after single suture placement for femoral access closure. Technical success was defined as achieving complete hemostasis without a bailout strategy. Vascular complications and bleeding were defined by Valve Academic Research Consortium-3 (VARC-3) criteria. Vascular access changes and 30-day mortality were recorded.

The technique success rate for the entire study population was 100% (55 femoral access in 37 patients; median age: 72; 78% males). The mean sheath size was 20.4 ± 2.3F. The mean manual compression time was 3.5 ± 1.4 min, the mean hemostasis time was 9.0 ± 2.5 min, and the mean procedural time was 103.9 ± 34.7 min. One patient (1.6%) developed an access site infection and recovered conservatively. No VARC-3 vascular complications and access changes were observed. No 30-day mortality happened.

The hybrid Glubran-supported single-Proglide technique is feasible for large bore access closure during EVAR and may be a viable alternative; however, larger prospective studies are required to confirm its efficacy.