Managing risk of complications at femoral vascular access sites in percutaneous coronary intervention

Area of Science:

• Cardiology
• Vascular Medicine
• Nursing

Background:

• Percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) or non-ST-elevation myocardial infarction (NSTEMI) necessitates potent antiplatelet and antithrombin therapies.
• While enhancing PCI efficacy, these potent antithrombotic agents elevate the risk of vascular access complications.

Purpose of the Study:

• To review the risks associated with potent antithrombotic agents used in PCI.
• To identify modifiable and nonmodifiable risk factors for vascular access complications.
• To emphasize the role of nurses in mitigating these complications.

Main Methods:

• Literature review of studies on PCI, antithrombotic agents, and vascular access complications.
• Analysis of risk factors, including procedural techniques, medications, hemostasis, patient demographics, and physiological parameters.
• Discussion of nursing interventions for complication identification and management.

Main Results:

• Vascular access complications include hematoma, retroperitoneal hematoma, pseudoaneurysm, arterial occlusion, and arteriovenous fistula.
• Complications are linked to increased morbidity, mortality, and healthcare costs.
• Risk factors are categorized as modifiable (e.g., procedure technique, medications) and nonmodifiable (e.g., age, sex, BMI, renal function).

Conclusions:

• Nurses play a critical role in recognizing and managing vascular access complications post-PCI.
• Knowledge of risk factors empowers nurses to implement preventative strategies and early interventions.
• Effective nursing care can reduce the incidence and severity of complications, improving patient safety and outcomes.