Vascular access and cardiac complications after PCI: In- and out-of-hospital outcome issues

Abstract

Background: Despite the rapid increase in percutaneous coronary intervention (PCI) rates, vascular complications remain a possible source of impaired outcomes for patients. Moreover, management of complications is an integral part of cardiac nurses’ roles and responsibilities. Aim: The aim of this quality review was to highlight the in-hospital and out-of-hospital complications up to 12 months post-discharge following PCI. Methods and Results: A review of prospectively-collected data from the Angioplasty Database run by the research institute of 1089 consecutive patients who had PCI procedures from 1 January 2005– 31 December 2006 was conducted. The in-hospital vascular complications included bleeding/ooze only (22.4%) and haematoma only (7.1%). The in-hospital cardiac outcomes included one death(0.09%) following PCI. In addition, a sample of 525 (52%) patients were followed up at 1 month and 12 months post-procedure. Vascular complications were 2.5% and 4% respectively. Cardiac complications included repeat angiogram (9.7%) and repeat PCI (3.6%). Conclusions: Vascular outcomes pose ongoing problems for patients both in and out of hospital. The results suggest that cardiac nurses need to further improve monitoring of their patient outcomes following PCI.

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

“…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.…”

“…Patients should be informed about what is awaiting them, possible complication development during recovery process and how they can get appropriate support [7]. Thus, patient's anxiety can diminish and compliance to treatment can be enhanced.…”

“…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].…”

Empowerment of the Rural Parents/Caregivers of Children with Heart Diseases in Namibia to Facilitate Coping with the Demands of Caring at Home

“…Other aspects which influence the children's vitality and therefore which need to be addressed are: adherence to the medications, cardiac diet and nutrition, management of the child's body weight, modification of child's lifestyles, as well as the modification of the environment. It is therefore indicated that caregivers be knowledgeable and skillful about aspects of medications such as dosages and side effects and to seek the assistance of a health care provider should the child experience side-effects from the medications ( Higgins, Thoebald, & Peter, 2008 ; Reinhard, 2008; Grubb & Newy, 2006; Travis, Bethia, & Winn, 2000; Scherbring, 2002; Bucher et al, 2001; Schumacher, Stewart, Archbold, Dodd, & Dibble, 2000 ).…”

Enhancing Outcomes for Outpatient Percutaneous Coronary Interventions

“… 16 Training in the recovery areas should also be validated through return demonstration to ensure that nurses can correlate acute clinical changes with impending complications. 17 – 19 Finally, postdischarge teaching can be effectively conducted in the recovery setting. Percutaneous coronary intervention recovery nurses should become comfortable with one-on-one teaching sessions with their patients, where customized concerns can be addressed to promote a stronger sense of support and self-efficacy.…”