Propensity score analysis of vascular complications after diagnostic cardiac catheterization and percutaneous coronary intervention 1998–2003

Applegate, Robert J.; Sacrinty, Matthew; Kutcher, Michael A.; Baki, Talal T.; Gandhi, Sanjay; Santos, Renato M.; Little, William C.

doi:10.1002/ccd.20677

Cited by 60 publications

(58 citation statements)

References 20 publications

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“…There has been a significant improvement in overall rates of complication among both men and women, however, women remain at a significantly higher risk. 21 Our current analysis represents one of the largest multicenter PCI reports in women and spans an era of contemporary practice. In parallel, but separate analysis of men and women undergoing PCI, clinical and procedural variables, such as older age, renal insufficiency, cardiogenic shock, and large sheath sizes were significant independent predictors of bleeding/VC in both genders.…”

Section: Discussionmentioning

confidence: 99%

Significantly Improved Vascular Complications Among Women Undergoing Percutaneous Coronary Intervention

Ahmed

Piper

Malenka

et al. 2009

Circ: Cardiovascular Interventions

150

105

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Background-Women are at a higher risk for bleeding/vascular complications (VC) related to cardiovascular procedures.Although the overall incidence of percutaneous coronary intervention (PCI)-related bleeding/VC has declined, the impact of this decline, specifically in women, is unknown. Methods and Results-We studied 13 653 female and 32 334 male consecutive cases, from 2002 to 2007, in the Northern New England PCI Registry. We sought to (1) compare absolute rates of bleeding/VC in women and men over time, (2) define predictors of bleeding/VC in women and men undergoing PCI, and (3) trend the impact of female gender in predicting bleeding/VC over time. Bleeding/VC was defined as any access-site vessel injury requiring surgical intervention or bleeding requiring transfusion. The overall risk of bleeding/VC was significantly higher in women versus men (4.5Ϯ1.3% versus 1.6Ϯ0.5%; PϽ0.004). Over time, there was a significant (PϽ0.001) 50% decrease in absolute bleeding/VC rates in both women and men. After adjustment for baseline differences, female gender remained a significant predictor of increased risk in 2007 (odds ratio, 2.6; 95% CI, 1.74 to 3.91). Independent predictors of increased risk of bleeding/VC in women included older age, shock, renal failure, presentation with non-ST-elevation myocardial infraction and larger sheath sizes, whereas the use of fluoroscopy-guided access, closure devices, history of dyslipidemia or prior PCI, and use of bivalirudin were protective. Conclusion-Women undergoing PCI have had a significant decline in bleeding/VC rates during the last 6 years. Despite the improvement in procedural safety, female gender continues to be associated with a Ͼ2-fold risk of bleeding/VC compared with men. (Circ Cardiovasc Intervent. 2009;2:423-429.)

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Section: Discussionmentioning

confidence: 99%

Significantly Improved Vascular Complications Among Women Undergoing Percutaneous Coronary Intervention

Ahmed

Piper

Malenka

et al. 2009

Circ: Cardiovascular Interventions

150

105

View full text Add to dashboard Cite

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“…A number of meta-analyses and randomized and nonrandomized studies have shown variable results. Some studies have shown efficacy equivalent to that of manual compression, 24,25 and a few have shown superiority of these devices to manual compression. 26 -29 However, other studies have expressed concern about an increased risk of complications with these devices.…”

Section: Vascular Closure Devicementioning

confidence: 99%

Femoral Arterial Access and Closure

Bangalore

Bhatt

2011

Circulation

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“…Previous reports have shown that pseudoaneurysm develops from vascular wall damaged by catheterization, and secure astriction could prevent development of pseudoaneurysm [7]. Secured astriction can also reduce subcutaneous hemorrhage after catheterization, which is effective for decreasing median nerve palsy caused by hematoma following catheterization [7].…”

Section: Discussionmentioning

confidence: 99%

High Median Nerve Palsy Caused by Pseudoaneurysm After Brachial Catheterization: Two Case Reports

et al. 2017

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We here present two very rare cases of high median nerve palsy caused by pseudoaneurysm after brachial catheterization. A 71-yearold woman developed high median nerve palsy 2 weeks after brachial catheterization. She underwent pseudoaneurysm resection together with neurolysis 4 months after the onset of palsy. Surgical findings suggested that her palsy was caused by both severe compression by pseudoaneurysm and adhesion following hematoma after catheterization. Five months after the surgery, she only had slight sensory disturbance. A 48-year-old lady developed high median nerve palsy 1 week after the catheterization. Simple pseudoaneurysm resection was performed 2 weeks after the catheterization. Neurolysis was not performed. Seven months after the surgery, she still had severe sensory disturbance. Our cases suggested importance of secured astriction after catheterization, and recommended surgical procedure for this condition is combination of pseudoaneurysm resection and neurolysis by hand surgeons.

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Propensity score analysis of vascular complications after diagnostic cardiac catheterization and percutaneous coronary intervention 1998–2003

Abstract: In this large single-center, contemporary observational study, the risk-adjusted occurrence of vascular complications following VCD use for femoral artery access management is not increased by VCD use. Thus, in the current era, the benefit of VCD use is not offset by reduced safety.

Cited by 60 publications

References 20 publications

Significantly Improved Vascular Complications Among Women Undergoing Percutaneous Coronary Intervention

Significantly Improved Vascular Complications Among Women Undergoing Percutaneous Coronary Intervention

Femoral Arterial Access and Closure

High Median Nerve Palsy Caused by Pseudoaneurysm After Brachial Catheterization: Two Case Reports

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