Femoral Artery Complications after Cardiac Catheterization: A Study of Patient Profile

Castillo-Sang, Mario; Tsang, Albert W.; Almaroof, Babatunde; Cireddu, James; Sferra, Joseph; Zelenock, Gerald B.; Engoren, Milo; Kasper, Gregory

doi:10.1016/j.avsg.2009.06.025

Cited by 35 publications

(22 citation statements)

References 27 publications

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“…7, 8 Consistent with the findings of prior studies, the risk of vascular complications was not any higher among the relatively small group of patients who had a therapeutic INR during the procedure than the rest of the study subjects who discontinued warfarin and used LMWH prior to the procedure. 9 …”

Section: Discussionsupporting

confidence: 85%

“…The increased risk of procedure-related bleeding with clopidogrel has been well established in the surgical literature and its use is a risk factor for peripheral vascular complications in patients undergoing cardiac catheterization. 7,8 Consistent with the findings of prior studies, the risk of vascular complications was not any higher among the relatively small group of patients who had a therapeutic INR during the procedure than the rest of the study subjects who discontinued warfarin and used LMWH prior to the procedure. 9 This study demonstrated that procedure performed in July or August is also an independent risk factor.…”

Section: Vascular Complicationssupporting

confidence: 85%

“…2 Consistent with the findings of this study, a prior study demonstrated that women were more likely to experience vascular complications than men. 7,17 An overall complication rate of 5% with age >70 years and female gender as predictors of major complications were reported in another study. 18 However, the novel findings of this study include the adverse effect of concomitant therapy with clopidogrel on vascular complications, the higher risk of vascular complications early during the academic teaching year, and increased risk of pericardial tamponade after prior RFA for AF.…”

Section: Prior Studiesmentioning

confidence: 83%

See 2 more Smart Citations

Prevalence and Predictors of Complications of Radiofrequency Catheter Ablation for Atrial Fibrillation

Baman

Jongnarangsin

Chugh

et al. 2011

Journal of Cardiovascular Electrophysiology

112

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Introduction Up to 6% of patients experience complications after radiofrequency catheter ablation (RFA) of atrial fibrillation (AF). The purpose of this study is to determine the prevalence and predictors of periprocedural complications after RFA for AF. Methods and Results The subjects were 1295 consecutive patients (age=60±10 years) who underwent RFA (n=1642) for paroxysmal (53%) or persistent AF (47%) from January 2007 to January 2010. A complication occurred in 57 patients (3.5%); a vascular access complication in 31 (1.9%); pericardial tamponade in 20 (1.2%); a thromboembolic event in 4 (0.2%); deep venous thrombosis in 1 (<0.01%); and pulmonary vein stenosis in 1 patient (<0.01%). There were no procedure-related deaths. On multivariate analysis, female gender (OR=2.27; ±95% CI: 1.31–2.57, P<0.01) and procedures performed in July or August (OR=2.10; ±95% CI: 1.16–3.80, P=0.01) were independent predictors of any complication. For vascular complications, treatment with clopidogrel (OR=4.40; ±95% CI: 1.43–13.53, P=0.01), female gender (OR=3.65; ±95% CI: 1.72–7.75, P<0.01) and performing RFA in July or August (OR=2.71; ±95% CI: 1.25–5.87, P=0.01) were independent predictors. The only predictor of cardiac tamponade was prior RFA (OR=3.32; ±95% CI: 0.95–11.61; P<0.05). Conclusion Prevalence of perioperative complications for RFA of AF is 3.5% and vascular access complications constitute the majority. The need for clopidogrel therapy should be carefully considered prior to RFA. At teaching institutions close supervision should be exercised during vascular access early in the year. Improvements in ablation technology and elimination of the need for repeat procedures may decrease the risk of pericardial tamponade.

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Section: Discussionsupporting

confidence: 85%

Section: Vascular Complicationssupporting

confidence: 85%

Section: Prior Studiesmentioning

confidence: 83%

See 1 more Smart Citation

Prevalence and Predictors of Complications of Radiofrequency Catheter Ablation for Atrial Fibrillation

Baman

Jongnarangsin

Chugh

et al. 2011

Journal of Cardiovascular Electrophysiology

112

View full text Add to dashboard Cite

show abstract

“…Furthermore, thrombus aspiration can be performed using this method; thus, its success rate is higher than that of the right radial artery method 10. However, the femoral artery method is associated with more postoperative complications than its counterpart, such as pseudoaneurysms, vagal reflex responses, and retroperitoneal hematomas that may require blood transfusion or lead to death in severe cases 11. In addition, ACTs must be measured for 6 hours after surgery, and the arterial sheath must be removed under ECG monitoring.…”

Section: Discussionmentioning

confidence: 99%

Emergency Percutaneous Coronary Intervention Through the Left Radial Artery is Associated with Less Vascular Complications than Emergency Percutaneous Coronary Intervention Through the Femoral Artery

Qi¹,

Sun²,

Xia³

et al. 2017

Clinics

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OBJECTIVE:To compare the advantages and disadvantages of emergency percutaneous coronary intervention through the left radial artery with those of emergency percutaneous coronary intervention through the femoral artery.METHODS:A total of 206 patients with acute myocardial infarction who required emergency percutaneous coronary intervention and were admitted to our hospital between January 2011 and August 2013 were divided into the following two groups: a group that underwent percutaneous coronary intervention through the left radial artery and a group that underwent percutaneous coronary intervention through the femoral artery. The times required for angiographic catheter and guiding catheter placement, the success rate of the procedure and the incidence of vascular complications in the two groups were observed.RESULTS:There was no significant difference in catheter placement time or the ultimate success rate of the procedure between the two groups. However, the left radial artery group showed a significantly lower incidence of vascular complications than the femoral artery group (p<0.05).CONCLUSION:Emergency percutaneous coronary intervention through the left radial artery is associated with less vascular complications than emergency percutaneous coronary intervention through the femoral artery and is thus potentially advantageous for patients.

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“…Die meisten Veröffentlichungen beschäftigen sich mit dem Management und Outcome dieser extrahospitalen Verletzungen [6,8,14]. Über die Inzidenz und das Management iatrogener Gefäßverletzungen berichtet die Literatur jedoch nur spärlich, es sind lediglich Studien zu spezifischen Komplikationen bei einzelnen Prozeduren zu finden [15,16]. Im vorliegenden Kollektiv ist die Mehrheit aller Gefäßverlet-zungen iatrogenen Ursprungs, offensichtlich, da zunehmend komplexe und katheterbasierte Techniken in der Medizin Verwendung finden.…”

Section: Versorgungszeitpunkt Operationstechniken Versorgungsabläufeunclassified

Häufigkeit und Ursachen operationsbedürftiger vaskulärer Komplikationen bei nicht gefäßchirurgischen Patienten

Pongratz¹,

Reeps²,

Eckstein³

2011

Zentralbl Chir

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Arterial and venous vascular injuries are known but rare complications of severe multiple traumatised patients but are meanwhile more frequently induced iatrogenically. However there are only few reports about incidence, causes, surgical techniques and prognosis of these vascular emergencies. We have therefore analysed the causes, type of therapy, localisation of injury, primary dis-ease, morbidity and mortality of all vascular emergencies in patients without preexisting vascular disease. 2.9 % of all vascular repairs in our unit had to be performed for cases of iatrogenic (87 %) and non-iatrogenic (13 %) vascular complications. The overall mortality and major complication rate of these intrahospital iatrogenically aquired lesions were 4.8 % and 5 %, respectively, which are clearly below those of extrahospital vascular injuries. Thereby the observed increase of iatrogenic vascular injuries seems to be due to the increase in complex and even catheter-based techniques in modern therapy. The iliacofemoral region was affected in 45 % of the cases, in 50 % complex reconstructions and specific surgical skills were needed for the repair. This article on the incidence of and reasons for vascular iatrogenic lesions shows the importance of a planned management for the prognosis of these injuries.

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Femoral Artery Complications after Cardiac Catheterization: A Study of Patient Profile

Cited by 35 publications

References 27 publications

Prevalence and Predictors of Complications of Radiofrequency Catheter Ablation for Atrial Fibrillation

Prevalence and Predictors of Complications of Radiofrequency Catheter Ablation for Atrial Fibrillation

Emergency Percutaneous Coronary Intervention Through the Left Radial Artery is Associated with Less Vascular Complications than Emergency Percutaneous Coronary Intervention Through the Femoral Artery

Häufigkeit und Ursachen operationsbedürftiger vaskulärer Komplikationen bei nicht gefäßchirurgischen Patienten

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