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Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
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Major femoral vascular access complications after coronary diagnostic and interventional procedures: A Danish

Ditte Dencker1, Frants Pedersen2, Thomas Engstrøm2

  • 1Department of Radiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.

International Journal of Cardiology
|October 9, 2015
PubMed

Insights

Vascular complications from femoral access during coronary angiography are rare (0.54%). Key risk factors include left-sided access, peripheral arterial disease, and female sex, informing safer vascular management strategies.

Area of Science:

  • Cardiology
  • Vascular Surgery
  • Interventional Cardiology

Background:

  • Vascular access complications following coronary angiography (CAG) and percutaneous coronary intervention (PCI) increase patient morbidity, hospitalization duration, and healthcare costs.
  • Identifying risk factors and enhancing vascular management safety are crucial for improving patient outcomes in cardiovascular procedures.
  • Femoral access is a common route for CAG and PCI, necessitating a thorough understanding of its associated complications.

Purpose of the Study:

  • To determine the incidence of major vascular complications associated with femoral access during CAG and PCI.
  • To identify significant risk factors contributing to the occurrence of these vascular complications.

Main Methods:

  • A retrospective analysis of 23,870 index trans-femoral procedures (CAG) performed over six years in two centers.
  • Data prospectively collected and entered into a database, cross-matched with national vascular registry data.
  • Collection of demographic, procedural, mortality data, and information on access complications requiring surgery within 30 days.

Main Results:

  • A total of 130 (0.54%) access complications requiring surgery were identified, including pseudoaneurysms (0.28%), arterial occlusions (0.19%), and hematomas (0.06%).
  • Significant risk factors for complications included left-sided femoral access (OR 4.11), peripheral arterial disease (PAD) (OR 2.42), and female sex (OR 2.22).
  • Arterial dissections were identified in 0.02% of cases.

Conclusions:

  • The overall incidence of vascular complications related to femoral access in coronary diagnostic and interventional procedures is low at 0.54%.
  • Left-sided femoral access, presence of peripheral arterial disease (PAD), and female sex are identified as significant risk factors for these complications.
  • Findings underscore the importance of considering these risk factors for optimized vascular management and patient safety.
Abstract

Keywords:
ComplicationCoronary angiographyFemoral accessPercutaneous coronary intervention

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