***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
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    Input: OBJECTIVES The aim was to investigate whether the fascia suture technique ( FST ) can reduce access closure time and procedural costs compared with the Prostar technique ( Prostar ) in patients undergoing endovascular aortic repair and to evaluate the short- and mid-term outcomes of both techniques . METHODS In this two center trial , 100 patients were r and omized to access closure by either FST or Prostar between June 2006 and December 2009 . The primary endpoint was access closure time . Secondary outcome measures included access related costs and evaluation of the short- and mid-term complications . Evaluation was performed peri- and post-operatively , at discharge , at 30 days and at 6 months follow up . RESULTS The median access closure time was 12.4 minutes for FST and 19.9 minutes for Prostar ( p < .001 ) . Prostar required a 54 % greater procedure time than FST , mean ratio 1.54 ( 95 % CI 1.25 - 1.90 , p < .001 ) according to regression analysis . Adjusted for operator experience the mean ratio was 1.30 ( 95 % CI 1.09 - 1.55 , p = .005 ) and for patient body mass index 1.59 ( 95 % CI 1.28 - 1.96 , p < .001 ) . The technical failure rate for operators at proficiency level was 5 % ( 2/40 ) compared with 28 % ( 17/59 ) for those at the basic level ( p = .003 ) . The proficiency level group had a technical failure rate of 4 % ( 1/26 ) for FST and 7 % ( 1/14 ) for Prostar , p = 1.00 , while corresponding rates for the basic level group were 27 % ( 6/22 ) for FST and 30 % ( 11/37 ) for Prostar ( p = .84 ) . There was a significant difference in cost in favor of FST , with a median difference of € 800 ( 95 % CI 710 - 927 , p < .001 ) . CONCLUSIONS In aortic endovascular repair FST is a faster and cheaper technique than the Prostar technique OBJECTIVE The first multicenter r and omized controlled trial was design ed and conducted to assess the safety and effectiveness of  totally percutaneous endovascular aortic aneurysm repair ( PEVAR )  with use of a 21F endovascular stent graft system and either an 8 F or 10 F suture-mediated closure system ( the PEVAR trial , NCT01070069 ) . A noninferiority trial design was chosen to compare percutaneous access with st and ard open femoral exposure . METHODS Between 2010 and 2012 , 20 U.S. institutions participated in a prospect i ve , Food and Drug Administration-approved r and omized trial to evaluate percutaneous femoral artery access and closure by a " preclose " technique in conjunction with endovascular abdominal aortic aneurysm repair . A total of 151 patients were allocated by a 2:1 design to percutaneous access/closure ( n = 101 ) or open femoral exposure ( n = 50 [ FE ] ) . PEVAR procedures were performed with either the 8 F Perclose ProGlide ( n = 50 [ PG ] ) or the 10 F Prostar XL ( n = 51 [ PS ] ) closure devices . All endovascular abdominal aortic aneurysm repair procedures were performed with the Endologix 21 F profile ( outer diameter ) sheath-based system . Patients were screened by computed tomography with three-dimensional reconstruction and independent physician review for anatomic suitability and adequate femoral artery anatomy for percutaneous access . The primary trial end point ( treatment success ) was defined as procedural technical success and absence of major adverse events and vascular complications at 30 days . An independent access closure sub study evaluated major access-related complications . Clinical utility and procedural outcomes , ankle-brachial index , blood laboratory analyses , and quality of life were also evaluated with continuing follow-up to 6 months . RESULTS Baseline characteristics were similar among groups . Procedural technical success was 94 % ( PG ) , 88 % ( PS ) , and 98 % ( FE ) . One-month primary treatment success was 88 % ( PG ) , 78 % ( PS ) , and 78 % ( FE ) , demonstrating noninferiority vs FE for PG ( P = .004 ) but not for PS ( P = .102 ) . Failure rates in the access closure sub study analyses demonstrated noninferiority of PG ( 6 % ; P = .005 ) , but not of PS ( 12 % ; P = .100 ) , vs FE ( 10 % ) . Compared with FE , PG and PS yielded significantly shorter times to hemostasis and procedure completion and favorable trends in blood loss , groin pain , and overall quality of life . Initial noninferiority test results persist to 6 months , and no aneurysm rupture , conversion to open repair , device migration , or stent graft occlusion occurred . CONCLUSIONS Among trained operators , PEVAR with an adjunctive preclose technique using the ProGlide closure device is safe and effective , with minimal access-related complications , and it is noninferior to st and ard open femoral exposure . Training , experience , and careful application of the preclose technique are of paramount importance in ensuring successful , sustainable outcomes Introduction While endovascular aortic aneurysm repair ( EVAR ) has significantly reduced the morbidity associated with open surgery , efforts continue to minimise the surgical insult to the patient . We report our experience of percutaneous EVAR . Patients and methods Since June 2005 , 17/20 EVARs ( 85 % ) have been attempted percutaneously by deployment of two Perclose © devices into each femoral artery prior to passage of the device sheath . The sutures are left untied until the sheath is removed at the end of the procedure , when haemostasis is obtained . Patients were entered onto a prospect ively maintained data base and followed up at regular intervals in a dedicated EVAR clinic . Results Access and subsequent graft deployment was successful in all the 17 cases . The range of defects closed ranged from 12–24 Fr . Five patients ( 29 % ) required open groin exploration at the end of the procedure to achieve haemostasis . There was a significantly lower incidence of wound complications in the percutaneous EVAR group ( 6 vs. 10 % open cutdown cases , P < 0.05 , Mann – Whitney U test ) . Conclusion Percutaneous EVAR is both a feasible and safe method of performing endovascular abdominal aortic aneurysm repair , which is associated with a reduction in wound complication rates PURPOSE To evaluate safety and cost benefits of the percutaneous technique for treatment of aortic aneurysm , a prospect i ve r and omized study was performed that compared the endovascular suture technique with conventional cutdown access and repair . MATERIAL S AND METHODS From January 2002 through July 2002 , 30 endografts , including 14 Talent stent-grafts ( Medtronic , Sunrise , Fla ) and 16 Zenith endografts ( Cook , Bloomington , Ind ) were implanted in 30 patients for endovascular aneurysm treatment . The patients were r and omized to either  percutaneous technique ( group A ) or conventional cutdown ( group B ) . Fifty-five femoral arteries were cannulated with large-bore ( 14F-25F ) introducers and were included in the study . Safety and efficiency of both techniques were assessed by recording the complication rates , operation time , discharge , and time to ambulation . Comparison of selected estimated costs included both variable and fixed costs for femoral access and expenses for treatment of complications . RESULTS No operative deaths occurred . The complication rates were similar and included 1 arterial thrombosis in each group , 3 lymphoceles in group B , and 1 conversion to cutdown because of bleeding in group A. Mean surgery time ( 86.7 + /- 27 minutes vs 107.8 + /- 38.5 minutes ; P < .05 ) and time to ambulation ( 20.1 + /- 4.3 hours vs 33.1 + /- 18.4 hours ; P < .001 ) were significantly shorter in the group treated percutaneously . Because of the cost of the closure device , total cost of the percutaneous technique averaged 99.2 euro ; more than cutdown . CONCLUSIONS The percutaneous technique decreases the invasiveness of endovascular therapy of aortic aneurysm and reduces operative time and time to ambulation . Complications were roughly equivalent in severity . The additional cost for the device appears to justify its use for this form of aneurysm treatment PURPOSE This study was design ed to describe and evaluate our preliminary results with a percutaneous arterial closure device as compared to those obtained with conventional femoral surgical cut down during endovascular repair of abdominal aortic aneurysms ( AAA ) . MATERIAL AND METHODS Between January 2004 and December 2006 , 40 of 86 AAA patients selected for endovascular repair met the criteria for inclusion in this study . Nineteen of these patients ( Group A ) received a bifurcated endograft placed by direct puncture of the femoral arteries ( 38 femoral triangles ) with closure by a Prostar((R ) ) percutaneous arterial closure device ( Abbott ) . The other 21 patients ( control group B ) were managed with a bifurcated endograft placed by conventional open surgery ( 42 femoral triangles ) . Data concerning all 40 patients were collected prospect ively and analyzed . RESULTS The technical success rate was 92 % ( group A ) vs 90 % ( group B ) , P=0.79 . The incidence of perioperative complications was 16 % ( 3/19 ) in group A and 14 % ( 3/21 ) in group B ( P=0.89 ) . The mean hospital stay was 5.8 days in group A and 7.8 days in group B ( P=0.05 ) . The difference in the length of hospitalisation was associated with reduced cost for the percutaneous group ( 5579.60 euros vs. 7503.60 euros ; P=0.04 ) , that counterbalanced the cost induced by the Prostar XL((R ) ) suture mediated device . Mean follow-up in both groups was 12 months . The overall incidence of locoregional complications after one year of follow-up was 11 % ( 2/19 ) in group A and 19 % ( 4/21 ) in group B ( P=0.45 ) . CONCLUSION This study confirms the feasibility and safety of total percutaneous endovascular AAA repair . Our preliminary results suggest that the costs paid by healthcare providers for endovascular AAA repair might not be increased with the selective use of percutaneous closure devices Endovascular exclusion of abdominal aortic aneurysms ( AAAs ) was developed in an effort to treat patients who were at high risk for complications following st and ard surgical repair .  Stent grafts used for endovascular repair of AAAs require the use of large‐bore sheaths and surgical exposure of the common femoral arteries ( CFAs ) . To decrease the invasiveness of AAA repair , we attempted to perform the procedure percutaneously utilizing the Prostar XL Percutaneous Vascular Surgery Device and the preclose technique . Thirty patients underwent an attempted percutaneous AAA repair . These patients were followed prospect ively to assess the success of the procedure . Twenty‐eight patients ( 93 % ) had successful percutaneous repair of both CFA access sites . One patient had inadequate hemostasis of the 22 Fr CFA entry site and one patient had inadequate hemostasis of the 16 Fr CFA entry site . Both of these CFA sites underwent open surgical repair . The rate of successful repair of the 22 Fr CFA access site was 29 of 30 ( 96 % ) ; for the 16 Fr CFA access site , 29 of 30 ( 96 % ) . No in‐hospital groin complications were seen . The procedure time was 105 ± 21 min . The estimated blood loss was 90.6 ± 50 cc . The hemoglobin loss was 1.54 ± 0.89 mg/dL and the hematocrit loss was 5.04 % ± 2.8 % . Complete percutaneous endoluminal AAA repair is feasible using the preclose technique . CFAs with sheaths up to 22 Fr can be safely and successfully accessed and repaired percutaneously using this technique . This method provides secure hemostasis and reduces the invasiveness of procedures requiring large‐bore sheaths . Cathet Cardiovasc Intervent 2002;55:281–287 . © 2002 Wiley‐Liss , PURPOSE To evaluate prospect ively the safety and efficacy of totally percutaneous placement of abdominal and thoracic aortic endografts using the Prostar XL suture-mediated closure system . METHODS From January 2002 to January 2005 , we attempted to insert percutaneously all bifurcated abdominal aortic and thoracic endografts .  Consecutive patients ( 25 men , four women ) , with mean age 74.9 years ( range 44 - 84 ) , underwent endovascular repair for 20 abdominal aortic aneurysms ( AAA ) and nine thoracic aortic aneurysms ( repeat operation in one case ) . Endografts used included 21 Zenith ( Cook ) , eight Talent ( Medtronic ) 
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Moreover , percutaneous endovascular aneurysm repair did not increase the risk of haematoma , pseudoaneurysm , and arterial thrombosis or dissection .
Conclusion Percutaneous access demonstrates advantages over conventional surgical exposure for endovascular aneurysm repair , as indicated by access-related complications and hospital length of stay .