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Peer-reviewedCC BYAnnals of vascular diseases

Anatomical Risk Factors for Technical Failure of the Perclose Vascular Closure Device: A Single-Center Retrospective Study.

  • Hirofumi Jinno1
  • Shinsuke Kikuchi1
  • Tsutomu Doita2
  • Izumi Fukii1
  • Kyokei Fuchizawa1
  • Takayuki Uramoto1
  • Seima Ohira1
  • Keisuke Kamada1
  • Naoya Kuriyama1
  • Nobuyoshi Azuma1,3
  1. 1Department of Vascular Surgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.
  2. 2Department of Cardiovascular Surgery, Osaka University, Suita, Osaka, Japan.
  3. 3Department of Chronic Limb-Threatening Ischemia Research, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.
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Abstract

Objectives

Percutaneous large-bore femoral closure with the Perclose device is widely used, but technical failure remains clinically important. We identified anatomical risk factors for technical failure.Methods

We retrospectively analyzed endovascular aortic repair and endovascular therapy procedures using the Perclose device at the common femoral artery (CFA) between April 2020 and March 2025. Preoperative computed tomography (CT) measured CFA diameter, puncture depth, and a calcification score (0-4). Technical failure was defined as failure to achieve hemostasis with the intended deployment. Independent predictors were identified using patient-clustered generalized estimating equations.Results

Among 300 patients (485 limbs), technical failure occurred in 52 limbs (10.7%), of which 75.0% required surgical repair. Independent predictors were a higher calcification score (odds ratio [OR] 2.13 per 1-point increase; 95% confidence interval [CI] 1.37-3.31), an emergency procedure (OR 3.77; 1.55-9.14), a smaller CFA diameter (OR 1.16 per 1-mm decrease; 1.01-1.32), and a shallower puncture depth (OR 1.22 per 5-mm decrease; 1.01-1.47); the area under the curve was 0.72.Conclusions

Technical failure was driven by unfavorable CFA anatomy-heavy calcification, a small diameter, and a shallow puncture depth-and by emergency procedures. Preprocedural imaging assessment is essential; alternative closure or surgical cutdown should be considered in unfavorable or emergent cases.

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Cite

BibTeXRIS
BibTeX
@article{jinno2026anatomical,
  title = {{Anatomical Risk Factors for Technical Failure of the Perclose Vascular Closure Device: A Single-Center Retrospective Study.}},
  author = {Hirofumi Jinno and Shinsuke Kikuchi and Tsutomu Doita and Izumi Fukii and Kyokei Fuchizawa and Takayuki Uramoto and Seima Ohira and Keisuke Kamada and Naoya Kuriyama and Nobuyoshi Azuma},
  journal = {Annals of vascular diseases},
  year = {2026},
  month = oct,
  doi = {10.3400/avd.oa.26-00118},
  url = {https://europepmc.org/article/MED/42969012},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Anatomical Risk Factors for Technical Failure of the Perclose Vascular Closure Device: A Single-Center Retrospective Study.
AU  - Hirofumi Jinno
AU  - Shinsuke Kikuchi
AU  - Tsutomu Doita
AU  - Izumi Fukii
AU  - Kyokei Fuchizawa
AU  - Takayuki Uramoto
AU  - Seima Ohira
AU  - Keisuke Kamada
AU  - Naoya Kuriyama
AU  - Nobuyoshi Azuma
PY  - 2026
DA  - 2026/10/27
JO  - Annals of vascular diseases
DO  - 10.3400/avd.oa.26-00118
UR  - https://europepmc.org/article/MED/42969012
AB  - Objectives  Percutaneous large-bore femoral closure with the Perclose device is widely used, but technical failure remains clinically important. We identified anatomical risk factors for technical failure.Methods  We retrospectively analyzed endovascular aortic repair and endovascular therapy procedures using the Perclose device at the common femoral artery (CFA) between April 2020 and March 2025. Preoperative computed tomography (CT) measured CFA diameter, puncture depth, and a calcification score (0-4). Technical failure was defined as failure to achieve hemostasis with the intended deployment. Independent predictors were identified using patient-clustered generalized estimating equations.Results  Among 300 patients (485 limbs), technical failure occurred in 52 limbs (10.7%), of which 75.0% required surgical repair. Independent predictors were a higher calcification score (odds ratio [OR] 2.13 per 1-point increase; 95% confidence interval [CI] 1.37-3.31), an emergency procedure (OR 3.77; 1.55-9.14), a smaller CFA diameter (OR 1.16 per 1-mm decrease; 1.01-1.32), and a shallower puncture depth (OR 1.22 per 5-mm decrease; 1.01-1.47); the area under the curve was 0.72.Conclusions  Technical failure was driven by unfavorable CFA anatomy-heavy calcification, a small diameter, and a shallow puncture depth-and by emergency procedures. Preprocedural imaging assessment is essential; alternative closure or surgical cutdown should be considered in unfavorable or emergent cases.
SN  - 1881-641X
SN  - 1881-6428
ER  -