Objective To prospectively evaluate the safety and clinical outcomes of a no-drain approach for common femoral artery (CFA) exposure, challenging the routine use of closed suction drainage.Methods This single-centre, prospective, observational study (December 2023-June 2025) enrolled consecutive patients undergoing CFA exposure using a strict no-drain protocol.The primary endpoint was 30-day major adverse events (MAE: mortality, rehospitalisation, or surgical reintervention).Secondary endpoints included primary patency, graded wound complications at 14 and 30 days, and multivariate predictors of wound morbidity. ResultsWe analyzed 151 patients (median age 67; 78.1% male; 21.2% obese), with 67.5% undergoing hybrid procedures.The 30-day MAE rate was 8% (n=12), and 3-month primary patency was 97.4%.Early wound morbidity at 14 days included major dehiscence (16.5%) and superficial infection (10.6%), managed conservatively or with vacuum-assisted closure (VAC).Despite this early morbidity, major surgical re-operation for wound complications remained low at 2.6%.Multivariate analysis identified Body Mass Index (BMI) as the sole independent predictor of wound complications (aOR 1.14; 95% CI 1.06-1.23;P<0.001).Complication rates were similar between isolated CFA endarterectomy and hybrid procedures (21.4% vs 24.5%; P=0.32). ConclusionA no-drain approach for CFA exposure is feasible and yields a low rate of surgical re-operation, a profile that extends even to complex hybrid procedures.While early local wound J o u r n a l P r e -p r o o f 4 morbidity is notable and requires proactive management, it is primarily driven by patient phenotype, specifically obesity.
Desbois et al. (Wed,) studied this question.