Retroperitoneal bleeding after cardiac catheterization: a 7-year descriptive single-center experience

Area of Science:

• Cardiology
• Vascular Surgery
• Interventional Cardiology

Background:

• Retroperitoneal bleeding (RPB) is a rare but life-threatening complication following cardiac catheterization (CC).
• Limited contemporary data exists on RPB incidence and characteristics in the era of dual antiplatelet therapy and vascular closure devices (VCDs).

Purpose of the Study:

• To investigate the incidence, clinical presentation, and management of retroperitoneal bleeding (RPB) after cardiac catheterization (CC).
• To analyze risk factors and outcomes associated with RPB in the current therapeutic landscape.

Main Methods:

• Retrospective analysis of all RPB cases occurring after CC at Rabin Medical Center from 2005 to 2011.
• Inclusion of 48 RPB patients out of 26,487 undergoing CC, analyzing indications, interventions, medications, and management strategies.

Main Results:

• RPB occurred in 0.18% of patients, associated with younger age and female gender.
• Hemorrhagic shock presented in 39.6% of patients, with delayed bleeding onset observed in those using VCDs.
• Most patients (79.2%) were managed conservatively, with a 4.2% mortality rate attributed to RPB.

Conclusions:

• RPB is a rare but significant complication of CC, with distinct demographic associations.
• Vascular closure devices may delay the onset of RPB, necessitating vigilant monitoring.
• Prompt diagnosis and conservative management are effective in the majority of RPB cases following CC.