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Updated: Apr 1, 2026

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Published on: August 8, 2025
Risk Factors for Puncture Site Complications After Endovascular Procedures in Patients With Peripheral Arterial
Gerald Hackl1, Thomas Gary2, Klara Belaj2
1Division of Angiology, Department of Internal Medicine, Medical University of Graz, Graz, Austria gerald.hackl@medunigraz.at.
Objective:
To compare femoral access site closure techniques and to highlight risk factors for puncture site complications after lower extremity endovascular procedures.
Methods:
This retrospective study included 787 patients. Procedures were performed according to a standardized protocol. Puncture site complications within 24 hours were regarded as study end points.
Results:
Ninety (11.5%) puncture site complications were registered. Conventional manual compression (n = 87, 11.1%) was significantly associated with puncture site complications (odds ratio [OR] 2.08, P = .03). Body mass index > 25 kg/m(2) (OR 0.54, P = .01) and prothrombin time > 70% (OR 0.38, P = .04) were protective. All bleeding occurred in procedures >45 minutes. Blood pressure >200 mm Hg and below the knee (BTK) procedures were strong predictors for access site complications (OR 4.21, P = .01 and OR 3.33, P = .02).
Conclusions:
We observed an inferiority of conventional manual compression. Age, procedure duration > 45 minutes, BTK procedures, uncontrolled hypertension, and impaired coagulation were risk factors.
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