Related Experiment Video
Updated: Jun 20, 2026
Femoral Arterial and Venous Catheterization for Blood Sampling, Drug Administration and Conscious Blood Pressure and Heart Rate Measurements
Published on: January 24, 2012
Femoral artery complications after cardiac catheterization: a study of patient profile
Mario Castillo-Sang1, Albert W Tsang, Babatunde Almaroof
1The University of Toledo Health Science Campus, Toledo, OH 43614, USA. mcastillosang@utnet.utoledo.edu
Insights
Femoral artery complications after cardiac catheterization are common, with antithrombotic agents increasing risk. Vascular closure devices and male gender reduced complication rates in this study.
Area of Science:
- Cardiology
- Vascular Surgery
- Interventional Radiology
Background:
- Femoral artery complications following cardiac catheterization present a significant clinical challenge.
- These complications range from minor hematomas to severe events requiring surgical intervention, incurring substantial healthcare costs.
- The study addresses early femoral arterial complications in the context of modern cardiac catheterization practices, including closure devices and anticoagulation therapies.
Purpose of the Study:
- To evaluate early femoral arterial complications associated with percutaneous arterial access during cardiac catheterization.
- To identify factors contributing to or protecting against these complications in the era of closure devices and intense anticoagulation.
Main Methods:
- Retrospective chart review of 579 patients undergoing femoral artery catheterization between August 2005 and December 2005.
- Extraction of 46 data points, including demographics, comorbidities, anticoagulation, procedural details, and complications.
- Statistical analysis using univariable and binary logistic regression to identify risk factors.
Main Results:
- 14% (82 of 579) of patients experienced complications, primarily hematomas (10%) and active bleeding (2.4%).
- Increased risk was associated with preprocedural and intraprocedural antithrombotic agents, intraprocedural clopidogrel, postprocedural heparin, and coronary artery disease.
- Protective factors included the use of closure devices, male gender, and prior catheterization history.
Conclusions:
- Femoral artery complications remain a significant risk, particularly with complex procedures and potent antithrombotic therapies.
- Close postprocedural monitoring and the use of closure devices in high-risk patients are recommended to mitigate complications.
- The routine use of closure devices may not be necessary for low-risk patients, such as males or those with prior ipsilateral catheterization, warranting further investigation.
Background:
Femoral artery complications after cardiac catheterization range from simple events to severe complications requiring invasive techniques or surgery with significant economic costs. This study evaluated early femoral arterial complications from percutaneous arterial access during diagnostic and interventional cardiac catheterizations in an era of widespread use of closure devices and intense anticoagulation.
Methods:
Patients undergoing percutaneous cardiac catheterization via the femoral artery between August 2005 and December 2005 were identified using an ICD-9 patient database. Forty-six data points were extracted by retrospective chart review, including demographics, comorbidities, type of anticoagulation, procedural details, and postprocedural complications. Univariable analysis and binary logistic regression were used to determine factors associated with complications.
Results:
Eighty-two of 579 patients (14%) suffered complications. The most common complications were hematomas (51 patients, 10%) and active bleeding (14 patients, 2.4%). Closure devices were used in 470 patients. After multivariable correction, use of preprocedural (odds ratio [OR]=5.65, 95% confidence interval [CI] 2.58-12.3, p<0.001) and intraprocedural (OR=4.88, 95% CI 1.95-12.3, p<0.001) antithrombotic agents (antiplatelet and/or anticoagulants), intraprocedural clopidogrel (OR=2.98, 95% CI 1.21-7.30, p=0.017), and postprocedural heparin (OR=29.4, 95% CI 3.56-250, p=0.002) were associated with increased risk. Coronary artery disease was associated with increased risk (OR=11.1, 95% CI 4.78-25.6, p<0.001), while use of a closure device (OR=0.263, 95% CI 0.125-0.553, p<0.001), male gender (OR=0.421, 95% CI 0.220-0.805, p=0.009), and prior catheterization (OR=0.033, 95% CI 0.012-0.095, p<0.001) were protective.
Conclusion:
With increasing numbers of complex coronary endovascular procedures and widespread use of high-dose multidrug antithrombotic therapy, femoral artery injuries will continue to be a significant risk for patients. Postprocedural monitoring with a high level of suspicion and use of vascular closure devices in high-risk patients may decrease the incidence of femoral artery complications. The use of vascular closure devices after low-risk procedures in male patients or those with previous ipsilateral catheterization might not be warranted but needs further study.
More Related Videos
Related Concept Videos
01:26Cardiac Catheterization IV: Nursing Management
01:28Cardiac Catheterization I: Pre-Procedure Overview
01:21Cardiac Catheterization II: Right Heart Catheterization
01:24Cardiac Catheterization III: Left Heart Catheterization
01:21Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
01:30Acute Coronary Syndrome III: Diagnostic Studies