Does micropuncture technique really help reduce vascular complications?

Bogabathina, Hari; Singireddy, Sampath; Shi, Runhua; Morris, Liam; Abdulbaki, Abdulrahman; Zabher, Henock; Katikaneni, Pavan; Modi, Kalgi

doi:10.1016/j.carrev.2018.03.021

Cited by 11 publications

(4 citation statements)

References 18 publications

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“…74 Although some operators favour micropuncture needles in arterial or venous access, there are no clear data to suggest a benefit in terms of bleeding risk reduction. 170,171 This is also illustrated by Strobel et al examining percutaneous intraabdominal interventions and Atwell et al examining percutaneous biopsy. Both trials showed no significant increase in major bleeding when larger needles were used.…”

Section: Oper Ator a N D Procedu R A L R Isk Fac Tor S For Bl E Edi Ngmentioning

confidence: 89%

“…Reduced number of passes and fewer complications have also been observed in central venous catheter insertion when using ultrasound compared with the traditional landmark technique 74 . Although some operators favour micropuncture needles in arterial or venous access, there are no clear data to suggest a benefit in terms of bleeding risk reduction 170,171 . This is also illustrated by Strobel et al.…”

Section: Operator and Procedural Risk Factors For Bleedingmentioning

confidence: 99%

See 1 more Smart Citation

A British Society for Haematology guideline on the assessment and management of bleeding risk prior to invasive procedures

Lester,

Bent,

Alikhan

et al. 2024

Br J Haematol

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This guideline was compiled according to the British Society for Haematology (BSH) process at https:// b-s-h. org. uk/ . The Grading of Recommendations Assessment, Development and Evaluation (GRADE) nomenclature was used to evaluate the levels of evidence and to assess the strength of recommendations. The GRADE criteria can be found at http:// www. grade worki nggro up. org. A literature search was carried out using the terms given in Appendix.

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Section: Oper Ator a N D Procedu R A L R Isk Fac Tor S For Bl E Edi Ngmentioning

confidence: 89%

Section: Operator and Procedural Risk Factors For Bleedingmentioning

confidence: 99%

A British Society for Haematology guideline on the assessment and management of bleeding risk prior to invasive procedures

Lester,

Bent,

Alikhan

et al. 2024

Br J Haematol

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“…58 Another retrospective cohort did not show any reduction in access site complications with the micropuncture technique compared with standard access techniques. 59 Fluoroscopy-guided introduction of the guidewire is important to avoid the perforation of a small side branch with the subsequent risk of retroperitoneal hematoma. 57 The ongoing REBIRTH trial (Radial Versus State-of-the-Art Femoral Access for Bleeding and Access Site Complication Reduction in Cardiac Catheterization (https://www.clinicaltrials.gov; unique identifier: NCT04077762) is randomizing patients undergoing femoral access to standard or micropuncture needle.…”

Section: Optimalization Of Tfamentioning

confidence: 99%

Vascular Access in Percutaneous Coronary Intervention of Chronic Total Occlusions: A State-of-the-Art Review

Meijers

Aminian

Valgimigli

et al. 2023

Circ: Cardiovascular Interventions

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The outcomes of chronic total occlusion percutaneous coronary intervention have considerably improved during the last decade with continued emphasis on improving procedural safety. Vascular access site bleeding remains one of the most frequent complications. Several procedural strategies have been implemented to reduce the rate of vascular access site complications. This state-of-the-art review summarizes and describes the current evidence on optimal vascular access strategies for chronic total occlusion percutaneous coronary intervention.

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“…9 While unproven, smaller gauge needles (use of a micropuncture technique) may decrease the risk of complications from an unintentional arterial puncture during CVC placement. 10,11 More significant arterial injury following tract dilation or catheter placement is estimated to occur at a frequency of 0.1 to 1% and necessitates a more comprehensive workup including specialist consultation due to the higher rates of neurologic or hemorrhagic complications associated with inattentive management of this situation. 9 Many experienced clinicians believe that misplacement of smaller gauge catheters (≤7Fr triple lumen catheters) can be safely managed with a "pull-pressure" strategy (characterized by "pulling" the catheter out and applying "pressure" for 5-20 minutes) while acknowledging that larger bore catheters require removal with definitive open or endovascular repair.…”

Section: Case Presentationmentioning

confidence: 99%

Arterial Placement of Central Venous Catheters

Wierstra

Cantle

et al. 2020

Can Journ Gen Int Med

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Arterial misplacement of central venous catheters can often be avoided with the use of real-time ultrasound-guided procedural competency. However, misplacement can still occur and is more likely to occur when the internal jugular vein is located directly above the common carotid injury. The resultant injury to the common carotid artery occurs through the posterior wall of the internal jugular vein. Arterial injury may also occur when the subclavian vein is attempted in a non-ultrasound-guided fashion. Optimal management requires a coordinated evaluation of the catheter misplacement by Interventional Radiology and Vascular Surgery to ensure maximum patient safety during catheter removal. This article reviews the literature around this topic and provides a summary of the best approach to safely remove the misplaced catheter. Resume Le mauvais positionnement artériel des cathéters veineux centraux peut souvent être évité grâce à l'utilisation de compétences procédurales guidées par ultrasons en temps réel. Cependant, un mauvais positionnement peut toujours se produire et est plus susceptible de se produire lorsque la veine jugulaire interne est située directement au-dessus de la lésion carotidienne commune. La lésion de l'artère carotide commune qui en résulte se produit à travers la paroi postérieure de la veine jugulaire interne. Une lésion artérielle peut également se produire lorsque la veine sous-clavière n'est pas guidée par un ultrason. Une gestion optimale nécessite une évaluation coordonnée du mauvais positionnement du cathéter par la radiologie interventionnelle et la chirurgie vasculaire afin de garantir une sécurité maximale au patient lors du retrait du cathéter. Cet article passe en revue la littérature sur ce sujet et fournit un résumé de la meilleure approche pour retirer en toute sécurité le cathéter mal placé.

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Does micropuncture technique really help reduce vascular complications?

Cited by 11 publications

References 18 publications

A British Society for Haematology guideline on the assessment and management of bleeding risk prior to invasive procedures

A British Society for Haematology guideline on the assessment and management of bleeding risk prior to invasive procedures

Vascular Access in Percutaneous Coronary Intervention of Chronic Total Occlusions: A State-of-the-Art Review

Arterial Placement of Central Venous Catheters

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