Vascular complications after balloon and new device angioplasty.

Popma, Jeffrey J.; Satler, Lowell F.; Pichard, Augusto D.; Kent, Kenneth M.; A, Campbell; Chuang, Ya Chien; Clark, Chester E.; Merritt, Alan J.; Bucher, Theresa A.; Leon, Martin B.

doi:10.1161/01.cir.88.4.1569

Cited by 246 publications

(132 citation statements)

References 22 publications

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“…Similar procedures have a broad range of hemostatic complication rates for manual compression and VCD [10][11][12][13]. Depending on the definitions, the accuracy of follow-up protocols, and diagnostic tools used, complication rates as high as 64 % have been reported [14].…”

Section: Discussionmentioning

confidence: 99%

The Use of the “Preclosure” Technique for Antegrade Aspiration Thrombectomy with Large Catheters in Acute Limb Ischemia

Funke

Pfiffner

Husmann

et al. 2012

Cardiovasc Intervent Radiol

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PURPOSE: This study was designed to assess retrospectively short-and mid-term outcomes of the use of a suture-mediated closure device to close the antegrade access in patients undergoing percutaneous aspiration thrombectomy with large catheters for acute leg ischemia. METHODS: Between November 2005 and February 2010, a suture-mediated active closure system (ProGlide(®) 6F, Abbott) was placed before arterial sheath (mean 9 F, range 6-12 F) introduction in 101 patients (74 men, 73 %, mean age 70.1 ± 12.6 years standard deviation). Data regarding mortality, complications, and factors contributing to vascular complications at the access site was collected for 6 month after the intervention to detect device-related problems. As a coincidence, 77 patients had follow-up visits for a duplex ultrasound. RESULTS: There were a total of 19 vascular complications (19 %) at the puncture site, all of which were of hemorrhagic nature and none of which consisted of vessel occlusion. Two major outcome complications (2 %) occurred. A retroperitoneal hematoma and a serious inguinal bleeding required additive treatment and did not result in permanent sequelae. Nine cases involved death of which eight were not attributable to the closure and one remained unclear. Successful closure was achieved in 95 patients (94 %); additional manual compression was sufficient in the majority of the remaining patients. Numerous factors contributing to vascular complications were encountered. CONCLUSIONS: With acceptable short-and mid-term outcomes, the "preclose" technique can be a reliable option for the closure of a large antegrade femoral access even for patients at a high risk of vascular complications, such as those undergoing aspiration thrombectomy. Abstract Purpose This study was designed to assess retrospectively short-and mid-term outcomes of the use of a suturemediated closure device to close the antegrade access in patients undergoing percutaneous aspiration thrombectomy with large catheters for acute leg ischemia. Methods Between November 2005 and February 2010, a suture-mediated active closure system (ProGlide Ò 6F, Abbott) was placed before arterial sheath (mean 9 F, range 6-12 F) introduction in 101 patients (74 men, 73 %, mean age 70.1 ± 12.6 years standard deviation). Data regarding mortality, complications, and factors contributing to vascular complications at the access site was collected for 6 month after the intervention to detect device-related problems. As a coincidence, 77 patients had follow-up visits for a duplex ultrasound. Results There were a total of 19 vascular complications (19 %) at the puncture site, all of which were of hemorrhagic nature and none of which consisted of vessel occlusion. Two major outcome complications (2 %) occurred. A retroperitoneal hematoma and a serious inguinal bleeding required additive treatment and did not result in permanent sequelae. Nine cases involved death of which eight were not attributable to the closure and one remained unclear. Successful closure was achieved in 95 pati...

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Section: Discussionmentioning

confidence: 99%

The Use of the “Preclosure” Technique for Antegrade Aspiration Thrombectomy with Large Catheters in Acute Limb Ischemia

Funke

Pfiffner

Husmann

et al. 2012

Cardiovasc Intervent Radiol

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“…This can lead to a gradual decrease in elastic fibers, arterial wall rigidity, and increased risk of atherosclerosis and arterial thrombosis [28] . Many PCI-related vascular complications such as large hematomas in femoral regions, pseudoaneurysms, and arteriovenous fistulas have been also associated with advanced age [29] . Also, the gradual impairment of endothelial cells function that occur with aging leads to lower production of nitric oxide and prostacyclin which play an important role in promoting vasodilatation as well as preventing platelets aggregation [28,30] .…”

Section: Hematological and Vascular Changesmentioning

confidence: 99%

Percutaneous coronary intervention in the elderly: current updates and trends

Arisha¹,

Ibrahim²,

Abouarab³

et al. 2018

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Ischemic heart disease is the leading cause of death with acute coronary syndrome accounting for more than 30% of causes of mortality in the elderly population. The rate of growth of the older segment of the population has increased exponentially and will become more pronounced in the future. Historically, there has been a paucity of clinical trials investigating the challenges and outcomes of more invasive treatment strategies such as percutaneous coronary intervention (PCI) for that very segment of the population. However, the safety, efficacy, and outcomes of PCI in the older population have started to receive more attention, leading to some changes in their trends. There are several factors that make interventional cardiologists more resistant to direct the elderly to PCI. Most of these challenging factors, such as the complexity of coronary lesions, frailty, hematological and vascular changes, are discussed in this review. In addition. more advanced technologies have been introduced to PCI platform such as second-and thirdgenerations stents, several alternative approaches have been adopted like transradial approach and the usage of bivalirudin instead of heparin and GP IIb/IIIa inhibitor, and several imaging modalities have been optimized to assess patients' outcome and prognosis more accurately. Several recent studies have shown better results when these strategies are adopted. The most recent recommendations regarding performing PCI in the elderly are also discussed in this review.

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“…9 In patient with ACS, PCI via TFA was associated with increase incidence of access site complication are common. [10][11][12] These complications are an important cause of increased patient morbidity, longer hospital stay and higher hospital cost. 13 The superficial location of RA allows easy homeostasis with less bleeding complication.…”

Section: : Percentage Of Distribution Of Types Of Stent Usedmentioning

confidence: 99%

Tran-Radial Percutaneous Coronary Intervention (PCI) is Safe and Alternative to Conventional Trans-Femoral Approach: Our Experiences at Apollo Hospitals Dhaka

et al. 2012

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Background: Aim of the study was to assess the safety of the trans-radial Percutaneous coronary intervention (PCI) than conventional Trans-femoral approach by using either Bare-metal stents (BMS) and or Drug Eluting Stent (DES) like Sirolimus-eluting or Paclitaxel-eluting stent. Also to see its safety in regards of procedural time, quick mobilization, less complication and less radiation exposure.Methods: Total 117 patients were randomized from a total of 538 patients who had PCI at our center in the quantifying period. Total 130 stent deployed in 117 patients. Among the patients, Male: 100 and Female:17. Mean age were for Male: 55yrs, for Female: 57yrs. Associated Coronary artery disease (CAD) risk factors were Dyslipidemia, High Blood pressure, Diabetes Mellitus, Positive FH for CAD and Smoking (all male). Results: Our study shows 21.7% had trans-radial PCI. Among the study group; 72 (61.5%) were Dyslipidemic, 75 (64.1%) were hypertensive: 47(40.2%) patients were Diabetic, FH 29 (24.8%) and 33(33%) were all male smoker. Female patients were more obese (BMI M 27: F 29) and developed CAD in advance age. Common stented territory were LAD 51 (43.6%) followed by RCA 41 (35%) and LCX 27(23%). Average length and diameter of stented vessel were almost same in all territory. Territory wise multiple or overlapping stenting was done in LAD 3 (6 stents), RCA 1(2stents), LCX 4 (10 stents). Stent used: BMS 37 (28.5%), Sirolimus 41(31.5%), Paclitaxel 27 (21%), Everolimus 22 (16.9%), Biolimus 2 (1.5%) and Zotarolimus 1(0.75%). Less Procedural time, reduced radiation exposure, no procedural complication and overall better patient comfort were observed.Conclusion: Our study has revealed that trans-radial PCI is safe with reduced radiation exposure, quick mobilization of patient and no procedural complication in all the case, indicates it can be done routinely as an alternative to conventional Trans-femoral approach. DOI: http://dx.doi.org/10.3329/cardio.v5i1.12274 Cardiovasc. j. 2012; 5(1): 57-61

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Vascular complications after balloon and new device angioplasty.

Abstract: Vascular complications developed more frequently after new device angioplasty than after balloon angioplasty, with the risk for vascular complications directly related to the degree of periprocedural anticoagulation.

Cited by 246 publications

References 22 publications

The Use of the “Preclosure” Technique for Antegrade Aspiration Thrombectomy with Large Catheters in Acute Limb Ischemia

The Use of the “Preclosure” Technique for Antegrade Aspiration Thrombectomy with Large Catheters in Acute Limb Ischemia

Percutaneous coronary intervention in the elderly: current updates and trends

Tran-Radial Percutaneous Coronary Intervention (PCI) is Safe and Alternative to Conventional Trans-Femoral Approach: Our Experiences at Apollo Hospitals Dhaka

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