BACKGROUND: Complications of vascular access are one of the most common adverse events after coronary angiography and percutaneous coronary intervention (PCI) and are reported to occur in 1% to 9% of cases. There are conflicting reports of the association of vascular complications with the use of vascular closure devices (VCDs). The purpose of this study was to assess femoral arterial access-related vascular outcomes after invasive cardiology procedures with the routine use of VCDs. METHODS: A total of 12,937 consecutive patients were studied for inhospital outcomes through a prospective registry from January 2002 to December 2005. Of these, 6913 (53%) patients underwent PCI and 9996 (77%) patients received VCDs. Univariate and multivariate logistic regression analyses were used to determine the predictors of vascular complications. A propensity analysis of VCD use was performed to account for potential bias in the likelihood of using such devices. RESULTS: Vascular complications occurred in 0.7% of diagnostic angiography and 2.7% of PCI patients. The risk of vascular complications was significantly lower with closure device use compared with manual compression in both diagnostic angiography (0.5% vs 1.1%, P = .01*) and PCI (2.4% vs 4.9%, P < .001*) groups. Multivariate logistic regression analysis, after accounting for the propensity to use such devices, revealed that VCD use was associated with a 58% (95% CI 19%-88%) reduction in the risk of vascular complications in diagnostic procedures catheterization and a 42% (95% CI 17%-59%) reduction in PCI patients. CONCLUSIONS: In contemporary practice, VCDs offer reduced risk of vascular complications as compared with manual compression in appropriately selected patients undergoing diagnostic and therapeutic cardiac catheterizations.
BACKGROUND: Complications of vascular access are one of the most common adverse events after coronary angiography and percutaneous coronary intervention (PCI) and are reported to occur in 1% to 9% of cases. There are conflicting reports of the association of vascular complications with the use of vascular closure devices (VCDs). The purpose of this study was to assess femoral arterial access-related vascular outcomes after invasive cardiology procedures with the routine use of VCDs. METHODS: A total of 12,937 consecutive patients were studied for inhospital outcomes through a prospective registry from January 2002 to December 2005. Of these, 6913 (53%) patients underwent PCI and 9996 (77%) patients received VCDs. Univariate and multivariate logistic regression analyses were used to determine the predictors of vascular complications. A propensity analysis of VCD use was performed to account for potential bias in the likelihood of using such devices. RESULTS:Vascular complications occurred in 0.7% of diagnostic angiography and 2.7% of PCI patients. The risk of vascular complications was significantly lower with closure device use compared with manual compression in both diagnostic angiography (0.5% vs 1.1%, P = .01*) and PCI (2.4% vs 4.9%, P < .001*) groups. Multivariate logistic regression analysis, after accounting for the propensity to use such devices, revealed that VCD use was associated with a 58% (95% CI 19%-88%) reduction in the risk of vascular complications in diagnostic procedures catheterization and a 42% (95% CI 17%-59%) reduction in PCI patients. CONCLUSIONS: In contemporary practice, VCDs offer reduced risk of vascular complications as compared with manual compression in appropriately selected patients undergoing diagnostic and therapeutic cardiac catheterizations.
Authors: Sumeet Subherwal; Eric D Peterson; David Dai; Laine Thomas; John C Messenger; Ying Xian; Ralph G Brindis; Dmitriy N Feldman; Shaun Senter; Lloyd W Klein; Steven P Marso; Matthew T Roe; Sunil V Rao Journal: J Am Coll Cardiol Date: 2012-05-22 Impact factor: 24.094
Authors: Neil J Wimmer; Eric A Secemsky; Laura Mauri; Matthew T Roe; Paramita Saha-Chaudhuri; David Dai; James M McCabe; Frederic S Resnic; Hitinder S Gurm; Robert W Yeh Journal: Circ Cardiovasc Interv Date: 2016-04 Impact factor: 6.546
Authors: Usha S Govindarajulu; Marco Stillo; David Goldfarb; Michael E Matheny; Frederic S Resnic Journal: Stat Med Date: 2017-05-03 Impact factor: 2.373
Authors: John T Owens; Shaun Bhatty; Robert J Donovan; Andrea Tordini; Peter Danyi; Kalpesh Patel; Jacob A Wegelin; Ion S Jovin Journal: Int J Angiol Date: 2017-10-04
Authors: Amit Kumar; Michael E Matheny; Kalon K L Ho; Robert W Yeh; Thomas C Piemonte; Howard Waldman; Pinak B Shah; Richard Cope; Sharon-Lise T Normand; Sharon Donnelly; Susan Robbins; Frederic S Resnic Journal: Circ Cardiovasc Qual Outcomes Date: 2014-12-09