الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Cardiovascular diseases are associated with significant morbidity and mortality worldwide. Minimally invasive catheter-based procedures including transcatheter aortic valve implantation (TAVI), endovascular aneurysm repair (EVAR), and implantation of mechanical circulatory support (MCS) have achieved inclusive acceptance. Compared to conventional open surgery, minimally invasive catheter-based procedures have less post procedural complications. TAVI and EVAR require large bore arterial access which is associated with bleeding, vascular, and hospital-acquired complications. The incidence rate of bleeding and vascular complications associated with large bore arterial access is 20% in TAVI and 12–22% in EVAR. Steps for large bore arterial access include surgical versus percutaneous cutdown for femoral access followed by surgical versus percutaneous suture closure for femoral arteriotomy. Optimal site management of large bore arterial access is pivotal to reduce the bleeding, vascular, and hospital-acquired complications associated with large bore arterial access. We wanted to compare surgical cutdown versus percutaneous closure devices in site management of large bore arterial access. Participants planned for TAVI or EVAR with large bore arterial access more than 10 French were included, while participants with history of bypass surgery, malignancies, thrombophilia, or sepsis were excluded. A consecutive sample of 100 participants (mean age 74.66 ± 2.65 years, 61% males) was selected and 43 participants underwent either TAVI (72.1%) or EVAR (27.9%) with surgical cutdown (group 1) versus 57 participants underwent either TAVI (91.2%) or EVAR (8.8%) with percutaneous closure devices (group 2), respectively. The percentages of study participants who had hypertension and diabetes mellitus were 81.4% and 62.8% for group 1 versus 82.5% and 56.1% for group 2, respectively. The incidence rate of hematoma was significantly lower in group 2 versus group 1 (p = 0.014). The mean procedure time (minutes) and the median hospital stay (days) were significantly higher in group 1 versus group 2 (t(98) = − 2.631, p = 0.01, and U = 2.403, p = 0.018, respectively), and the c-reactive protein pre-procedure and the c-reactive protein post-procedure were significantly lower in group 2 versus group 1 (U = -2.969, p = 0.003, and U = -2.674, p = 0.007, respectively). Our study showed a lower incidence rate of complications as hematoma, a shorter procedure time, and a shorter hospital stay associated with percutaneous closure devices compared to surgical cutdown.