Common femoral artery antegrade and retrograde approaches have similar access site complications

Siracuse, Jeffrey J.; Farber, Alik; Cheng, Thomas W.; Raulli, Stephen J.; Jones, Douglas W.; Kalish, Jeffrey; Smeds, Matthew R.; Rybin, Denis; Schermerhorn, Marc L.; Initiative, Vascular Quality

doi:10.1016/j.jvs.2018.06.226

Cited by 32 publications

(20 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Yeow et al revealed that concomitant use of echo-guide puncture when performing antegrade cannulation of the CFA might reduce bleeding-associated complications [29]. In contrast, Siracuse et al revealed that there were no significant differences between antegrade and retrograde cannulations in the overall rates of hematoma (3% vs. 2.7%; p = 0.21) or hematoma requiring intervention (0.4% vs. 0.4%; p = 0.75) in 45,816 patients undergoing EVT [19]. For antegrade cannulation, this is controversial.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, in previous studies showing that ultrasoundguided puncture is useful, many of the cases are of retrograde approaches. In modern EVT, the antegrade approach is often required [19], and the purpose was to retroactively confirm whether ultrasound guidance is effective in the recent EVT situation. Hence, this study aimed to examine the risk factors for bleeding complications in EVT of FP lesions using real clinical data from our institution.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Ultrasound-guided puncture reduces bleeding-associated complications, regardless of calcified plaque, after endovascular treatment of femoropopliteal lesions, especially using the antegrade procedure: A single-center study

et al. 2021

View full text Add to dashboard Cite

Background A common complication of endovascular treatment for femoropopliteal lesions is bleeding at the vascular access site. Although risk factors of bleeding-associated complications at the approach site have been reported, the results have been inconclusive. Hence, this study aimed to assess the predictors of bleeding-associated complications at the approach site in patients undergoing endovascular treatment for femoropopliteal lesions. Methods This retrospective, single-center, observational study included consecutive patients who underwent endovascular treatment (n = 366, 75% male, 72.4±9.9 year) for peripheral arterial disease with claudication and critical limb ischemia in our hospital from January 2010 to December 2017. We divided the patients into bleeding and non-bleeding groups, depending on whether bleeding-associated complications occurred at the approach site. Bleeding-associated complications were defined according to the Bleeding Academic Research Consortium criteria types 2, 3, and 5. Results Altogether, 366 endovascular treatment procedures and 404 arterial accesses were performed for femoropopliteal lesions in 335 peripheral arterial disease patients with claudication and 69 critical limb ischemia patients. We recorded 35 postprocedural bleeding-associated complications at the approach site (9%), all of which were hematomas. The predictors of increased bleeding-associated complications were age ≥ 80 years (bleeding vs. non-bleeding group, 43% vs. 25%, p<0.05) and antegrade cannulation of the common femoral artery (48% vs. 69%, p<0.05). Ultrasound-guided puncture reduced bleeding-associated complications (odds ratio, 0.28; 95% confidence interval, 0.004–0.21; p<0.05). In contrast, there was no significant difference in puncture site calcification between the groups (bleeding vs. non-bleeding groups, 29% vs. 21%, p = 0.29). Conclusion Ultrasound-guided puncture is associated with a decrease in bleeding-associated complications at the approach site, regardless of the presence of calcified plaque. It is particularly effective and should be more actively used in patients aged ≥80 years and for antegrade cannulation of the common femoral artery.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Ultrasound-guided puncture reduces bleeding-associated complications, regardless of calcified plaque, after endovascular treatment of femoropopliteal lesions, especially using the antegrade procedure: A single-center study

et al. 2021

View full text Add to dashboard Cite

show abstract

“…In comparison, a study using the Vascular Quality Initiative database showed that 29.3% of patients undergoing infrainguinal vascular disease through antegrade CFA access had comorbid obesity. 16 Thus, our cohort may not accurately represent all patient populations undergoing similar interventions.…”

Section: Discussionmentioning

confidence: 99%

Ultrasonography-guided antegrade common femoral artery approach: Factors associated with access time

et al. 2020

View full text Add to dashboard Cite

Introduction: The aim of this study was to evaluate the feasibility and safety of ultrasonography-guided antegrade common femoral artery puncture and subsequent superficial femoral artery access without the aid of fluoroscopy. Factors that could affect access time were also assessed. Methods: A total of 294 cases from 218 consecutive patients (163 men, 55 women; mean age: 66.9 ± 12.7 years) who underwent lower extremity endovascular procedures were retrospectively evaluated. The time between the injection of local anesthetic and the insertion of the microsheath into the superficial femoral artery was measured. The common femoral artery diameter, cutis thickness, distance between arterial puncture site and common femoral artery bifurcation, degree of common femoral artery calcification, body mass index, and history of previous access were investigated to assess their relationship with access time. Furthermore, all cases were assessed with ultrasonography for access-site complications before discharge. Results: Technical success was achieved in 293 of 294 procedures (99.7%). The mean time for superficial femoral artery access was 1.9 ± 0.8 min (range, 0.7–3.7 min). Additional fluoroscopic guidance was needed in one case. There were moderately positive correlations of body mass index ( r = 0.75; p < 0.001) and cutis thickness ( r = 0.58; p < 0.001) with access time. The other variables failed to reveal significant correlations with access time. Five groin hematomas occurred after percutaneous transluminal angioplasty. Complications such as pseudoaneurysm, arteriovenous fistula, or retroperitoneal hematoma were not observed. Conclusion: Antegrade common femoral artery puncture with subsequent superficial femoral artery access conducted solely under ultrasonography guidance was feasible and safe. In addition, the antegrade access time showed positive correlations with body mass index and cutis thickness.

show abstract

“…8 Femoral access is a procedure that is widely accepted due to its history, operator training, and extensive knowledge in the recognition and management of its complications, the most frequent being: major bleeding, 9,10 localized hematoma, 11 local bleeding, pseudoaneurysm, among others. 11,12 However, in the last decade, radial access has been implemented as the best alternative over femoral access, since a lower incidence of complications has been described with the same clinical results. 13 However, different studies have shown a higher than expected incidence of radial artery obstruction (RAO), and although this has been considered a benign complication, some reports raise doubts about it.…”

mentioning

confidence: 99%

Arteriografía coronaria con acceso radial en la enfermedad coronaria aguda y su relación con la fuerza de agarre y la permeabilidad de la arteria radial (CARHANG)

Contreras¹,

Moreno-Bedoya²,

Jaramillo³

et al. 2021

Cardiovasc Metab Sci

View full text Add to dashboard Cite

Se han realizado pocas investigaciones sobre algunas complicaciones secundarias al acceso radial para la arteriografía coronaria en pacientes con SCA, como la pérdida de fuerza de prensión y la alteración del flujo radial. Estos no se evalúan de forma rutinaria, sin saber que pueden comprometer el desempeño de los oficios que requieren habilidades finas o actividades en la vida diaria. Material y métodos: Estudio prospectivo observacional de cohorte longitudinal, con una muestra de 77 pacientes con diagnóstico de SCA, sometidos a coronariografía de acceso radial. Para el análisis de los datos, se utilizó el paquete estadístico IBM SPSS ® V.21. Para la medición de la fuerza se utilizó un dinamómetro hidráulico de la marca Sahean Corporation ® y se realizó un análisis comparativo de muestras relacionadas; prueba t-Student y regresión logística binaria. Resultados: La proporción por sexo fue de 48.1% mujeres y 51.9% hombres, la mediana de edad fue 66 años (58)(59)(60)(61)(62)(63)(64)(65)(66)(67)(68)(69)(70)(71)(72). En la fuerza de agarre de los pacientes con acceso radial, encontramos una diferencia estadísticamente significativa entre la medición inicial y final p < 0.001 (IC del 95%: 1.59-4.07). Teniendo en cuenta los criterios de discapacidad para las actividades instrumentales de la vida diaria (IADL), realizamos un análisis estratificado, encontrando diferencias significativas por género (p < 0.05). Conclusiones: Se encontró una pérdida significativa de fuerza de agarre en ambos sexos, con valores de fuerza menores al óptimo para IADL, hallazgos hasta ahora explicados por el tipo de intervención que requiere estudios futuros.

show abstract

Common femoral artery antegrade and retrograde approaches have similar access site complications

Cited by 32 publications

References 21 publications

Ultrasound-guided puncture reduces bleeding-associated complications, regardless of calcified plaque, after endovascular treatment of femoropopliteal lesions, especially using the antegrade procedure: A single-center study

Ultrasound-guided puncture reduces bleeding-associated complications, regardless of calcified plaque, after endovascular treatment of femoropopliteal lesions, especially using the antegrade procedure: A single-center study

Ultrasonography-guided antegrade common femoral artery approach: Factors associated with access time

Arteriografía coronaria con acceso radial en la enfermedad coronaria aguda y su relación con la fuerza de agarre y la permeabilidad de la arteria radial (CARHANG)

Contact Info

Product

Resources

About