Vascular access complications after cardiac catheterisation: a nurse-led quality assurance program

Area of Science:

• Cardiology
• Vascular Surgery
• Interventional Radiology

Background:

• Vascular access complications following cardiac catheterization can lead to patient discomfort, extended hospital stays, and poorer outcomes.
• Assessing these complications is crucial for implementing quality improvement initiatives.

Purpose of the Study:

• To evaluate vascular access complications in patients undergoing cardiac catheterization.
• To compare complication rates with and without the use of vascular closure devices.
• To establish a local benchmark for future quality improvements.

Main Methods:

• A prospective, nurse-led, single-center survey was conducted over four months.
• Data collected on all consecutive patients undergoing cardiac catheterization.
• Vascular access complications were systematically recorded for radial and femoral procedures.

Main Results:

• Out of 564 procedures, 83% used femoral access and 14% used radial access. Closure devices were used in 136 femoral procedures.
• Overall hematoma rate was 9.6%. Severe complications (hemoglobin loss >2g, transfusion, or vascular repair) occurred in 1.2% of cases.
• Severe complications were absent in radial access procedures. Femoral diagnostic and interventional procedures had complication rates of 0.4% and 2.4%, respectively. Higher activated coagulation times were noted in complicated transfemoral interventions.

Conclusions:

• Severe vascular access complications were infrequent, particularly with radial access, and lower than reported in many studies.
• Aggressive anticoagulation was linked to increased complications, whereas closure device use showed no significant association.
• Future strategies will prioritize radial access and less aggressive anticoagulation for transfemoral interventions.