Peripheral vascular complications after conventional and complex percutaneous coronary interventional procedures

Area of Science:

• Cardiology
• Interventional Cardiology
• Vascular Surgery

Background:

• Vascular access site complications are a concern in cardiac catheterization.
• The impact of complex interventional procedures on these complications requires further investigation.

Purpose of the Study:

• To assess the association between complex cardiovascular interventional procedures and vascular access site complications.
• To identify risk factors for these complications.

Main Methods:

• Prospective screening of 2,400 cardiac catheterization procedures over 12 months.
• Comparison of complication rates between diagnostic, conventional angioplasty, and complex interventional procedures.
• Univariate analysis to identify predictors of vascular complications.

Main Results:

• Overall complication rate was 1.6% (39/2400), with complex interventions showing a significantly higher incidence (6.0%) compared to diagnostic (0.6%) and conventional angioplasty (2.6%).
• Key predictors included periprocedural heparin or fibrinolytic therapy, arterial sheath size ≥8Fr, patient age ≥65 years, and peripheral vascular disease.
• Complications were more frequent in procedures >2 hours or with arterial sheaths in situ >24 hours.

Conclusions:

• The incidence of vascular access site complications is low but significantly increases with complex cardiovascular interventional procedures.
• Patient age, comorbidities, procedural duration, sheath size, and antithrombotic therapy are important risk factors.