Comparative outcomes of Single and Dual Proglide Strategies in Endovascular Aortic Repair: A Multi-center Cohort Study.

Objective: To evaluate the safety and efficacy of single versus dual Proglide strategies for large-bore access closure (16-24F) after endovascular aortic repair (EVAR).

Methods: A multi-center, retrospective cohort study was conducted including patients who underwent percutaneous access EVAR from March 2023 to July 2024. Patients were categorized into two groups: those using dual Proglide strategy (DP group) and those using single Proglide strategy (SP group). The technical success was defined as achieving complete hemostasis without using a bailout procedure. The primary endpoint was access-related complications. Vascular complications and bleeding events were evaluated in accordance with the Valve Academic Research Consortium (VARC)-3 criteria.

Results: A total of 97 patients with 142 access sites were included in the DP group, while 112 patients with 165 access sites were assigned to the SP group. The baseline characteristics were similar. The technical success rates were comparable (DP vs. SP, 99.3% vs. 100%, P=0.940). The mean number of total devices used per access site was significantly lower in the SP group, with a mean of 1.22±0.41, compared to 2.04±0.19 in the DP group (P<0.001). Overall, the access-related complication rates were similar, with 6.3% for the DP group and 6.1% for the SP group (P=0.920). No major access-related complications were reported.

Conclusion: The single Proglide strategy emerges as a viable alternative in EVAR, reducing the use of closure devices while maintaining high safety and efficacy.