Predictors of Complications Following Sheath Removal With Percutaneous Coronary Intervention

Abstract

Of the 413 patients, 68 (16.5%) had a complication. Sixty-four (15.5%) developed hematomas ranging in size from 1 to 5 cm (n = 35, 8.5%) to greater than 5 cm (n = 29, 7.0%), 6 experienced bleeding (1.5%), 4 (1%) had arteriovenous fistulas, and 3 (0.7%) developed pseudoaneurysms. There were no significant differences for complications using manual, C-clamp, or arterial vascular closure device. Patients with a higher systolic blood pressure (135 vs 129; df = 410, P = .025) and of older age (66 vs 63; df = 411, P = .016) were significantly more likely to have complications. Clinically significant major vascular complications were low. Arterial closure devices, mechanical C-clamp, and manual compression all provide low and comparable complication risks following sheath removal in the era of antiplatelet and antithrombotic therapies. Patients who are older and those with elevated blood pressure should have their femoral access site closely monitored and be observed for vascular complications.

The Effect of Ice-Bag Applied to Femoral Region of Individuals with Percutaneous Coronary Intervention on Local Vascular Complications and Low Back-Pain

“…In our study it was found that at first follow-up hemorrhage developed in 11.7% of patients, ecchymosis in 15.9%, and pseudo-aneurysm in 1.0% in no application group. In Botti et al's study [27], ecchymosis was detected in 14.5% of patients, and in Sulzbach-Hoke et al's study [6] pseudo-aneurysm was detected in 1.9% of patients. In a study by Jones et al [26] hemorrhage was seen in 10.0% of patients, hematoma in 12.0%, and ecchymosis in 12.0%.…”

“…When studies were reviewed with regard to complications developing in hospital, it was observed that there were studies which had results of complication rates close to ours (16.5%-17%), less than ours (2.9%), and more than ours (35.7%-65%) [2][3][4][5][6][7][8]. These differences between the results of studies are thought to be originating from differences in methods for providing and maintaining haemostasis, mobilization time, intervention characteristics, and methodological differences like evaluation of complications and selection criteria.…”

“…While Farmanbar et al [33] reported that there were no hemorrhages or pseudo-aneurysms 30 days after discharge, Jones et al [26] found ecchymosis in 20.0% of patients, hematoma in 6.0% and hemorrhage in 1.0% five days after discharge. The studies were generally limited to complications that developed during hospital stay; in most cases complications that could develop after patient's discharge were not investigated [2,6].…”

“…Hemorrhage, hematoma, distal emboli, pseudo-aneurysm and arterial thrombosis are the most important vascular complications observed [1]. Studies show local vascular complications following PCI vary between 2.9% -65.0% [2][3][4][5][6][7][8].…”

“…In patient care, following diagnostic and interventional cardiology procedures the primary role of nurse is prevention of local vascular complications and provision of patient comfort [6,20,21]. Control of both local vascular complications and pain, which is an experience as old as human history, reduce patient's hospital stay and treatment costs [21].…”