METHODS: This was a prospective study carried out in normal subjects at the Vascular Laboratory, Department of Surgery, Hospital Kuala Lumpur, from March 2006 to September 2006. The study compared the popliteal artery blood flow during change of posture from the horizontal (supine) to the sitting position and the effect of intermittent pneumatic compression (IPC) of the foot and calf on popliteal artery blood flow immediately and 10 minutes after cessation of compression.
RESULTS: A total of 15 subjects involving 30 limbs were examined in this study. On comparing flows between the horizontal and sitting position, there was a mean reduction in blood flow of 23% (p < 0.005). Immediately after compression of the foot and calf, there was an increase in blood flow of between 4% and 35% with a mean of 15% (p < 0.05). Peak systolic flows at 10 minutes postcompression were 536 +/- 95 mL/min, which was still significantly higher than precompression measurements.
CONCLUSION: There is a significant reduction in popliteal artery blood flow on changing from the supine to the sitting position. Popliteal artery blood flow is higher than baseline after 15 minutes of intermittent pneumatic foot and calf compression. The increase in popliteal artery blood flow is still present 10 minutes after cessation of IPC.
MATERIALS AND METHODS: We retrospectively reviewed our experience of pEVAR between April 2013 and July 2014. Primary success of the procedure was defined as closure of a common femoral artery (CFA) arteriotomy without the need for any secondary surgical or endovascular procedure within 30 days.
RESULTS: In total there were 10 pEVAR cases performed in the study period, one case in Queen Elizabeth Hospital during visiting vascular service. Patients have a mean age of 73.4 year old (66-77 year old) The mean abdominal aortic size was 7.2 cm (5.6-10.0cm). Mean femoral artery diameter was 9.0 mm on the right and 8.9 mm on the left. Mean duration of surgery was 119 minutes (98- 153 minutes). 50% of patients were discharged at post-operative day one, 30%- day two and 20%- day three. Primary success was achieved in 9 patients (90%) or in 19 CFA closures (95%). No major complication was reported.
DISCUSSION: We believe that with proper selection of patients undergoing EVAR, pEVAR offers a better option of vascular access with shorter operative time, less post- operative pain, shorter hospital stay and minimises the potential complications of a conventional femoral cutdown.