Ditte Dencker1, Frants Pedersen2, Thomas Engstrøm2, Lars Køber2, Søren Højberg3, Michael B Nielsen4, Torben V Schroeder5, Lars Lönn6. 1. Department of Radiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark. Electronic address: dittedencker@gmail.com. 2. Department of Cardiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark. 3. Department of Cardiology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark. 4. Department of Radiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark. 5. Copenhagen Academy for Medical Education and Simulation, Capital Region, Copenhagen, Denmark. 6. Department of Radiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; Department of Vascular Surgery, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
Abstract
BACKGROUND: Vascular access complications after coronary angiography (CAG) and percutaneous coronary intervention (PCI) are known to increase morbidity, prolong hospitalization and raise hospital costs. Therefore, risk factor identification and improvement of safety strategies for vascular management are important. We aimed to assess the incidence of major vascular complications related to femoral access, and to identify potential risk factors. METHODS: Over a period of six years, 23,870 index procedures (CAG) were performed in two centres, prospectively entered in the database and retrospectively analysed. Data was obtained from the Eastern Danish Heart Registry and cross-matched with data from the Danish Vascular Registry. Index procedures were defined as the first trans-femoral procedure. Demographic, procedural and mortality data, as well as information on access complications requiring surgery within 30 days were collected. Mortality data were collected for minimum 12 months. RESULTS: We identified 130 (0.54%) access complications requiring surgery; 65 pseudoaneurysms (0.28%), 46 arterial occlusions (0.19%), 15 hematomas (nine groin and six retroperitoneal hematomas) (0.06%), and 4 arterial dissections (0.02%). Risk factors for complications were left sided femoral access (OR 4.11 [2.29-7.37] p<0.001), peripheral arterial disease (PAD) (OR 2.42 [1.48-3.94] p<0.0001) and female sex (OR 2.22 [1.51-3.24] p<0.0001). CONCLUSION: Vascular complications related to femoral access in coronary diagnostic and interventional procedures are low (0.54%). Risk factors were left sided access, PAD, and female sex.
BACKGROUND:Vascular access complications after coronary angiography (CAG) and percutaneous coronary intervention (PCI) are known to increase morbidity, prolong hospitalization and raise hospital costs. Therefore, risk factor identification and improvement of safety strategies for vascular management are important. We aimed to assess the incidence of major vascular complications related to femoral access, and to identify potential risk factors. METHODS: Over a period of six years, 23,870 index procedures (CAG) were performed in two centres, prospectively entered in the database and retrospectively analysed. Data was obtained from the Eastern Danish Heart Registry and cross-matched with data from the Danish Vascular Registry. Index procedures were defined as the first trans-femoral procedure. Demographic, procedural and mortality data, as well as information on access complications requiring surgery within 30 days were collected. Mortality data were collected for minimum 12 months. RESULTS: We identified 130 (0.54%) access complications requiring surgery; 65 pseudoaneurysms (0.28%), 46 arterial occlusions (0.19%), 15 hematomas (nine groin and six retroperitoneal hematomas) (0.06%), and 4 arterial dissections (0.02%). Risk factors for complications were left sided femoral access (OR 4.11 [2.29-7.37] p<0.001), peripheral arterial disease (PAD) (OR 2.42 [1.48-3.94] p<0.0001) and female sex (OR 2.22 [1.51-3.24] p<0.0001). CONCLUSION: Vascular complications related to femoral access in coronary diagnostic and interventional procedures are low (0.54%). Risk factors were left sided access, PAD, and female sex.
Authors: Alexander C Fanaroff; Pratik Manandhar; David R Holmes; David J Cohen; J Kevin Harrison; G Chad Hughes; Vinod H Thourani; Michael J Mack; Matthew W Sherwood; W Schuyler Jones; Sreekanth Vemulapalli Journal: Circ Cardiovasc Interv Date: 2017-10 Impact factor: 6.546
Authors: Ramya C Mosarla; Ehrin Armstrong; Yonatan Bitton-Faiwiszewski; Peter A Schneider; Eric A Secemsky Journal: J Soc Cardiovasc Angiogr Interv Date: 2022-08-20