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Arterial access-site complications after use of a vascular closure device related to puncture height

Benjamin Sartorius1, Michael Behnes2, Melike Ünsal1

  • 1First Department of Medicine, University Medical Centre Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.

BMC Cardiovascular Disorders
|February 18, 2017
PubMed

Insights

This study found no significant differences in bleeding complications after percutaneous coronary intervention (PCI) when using vascular closure devices (VCDs) based on femoral arterial puncture height. Puncture location did not impact major bleeding events.

Area of Science:

  • Cardiology
  • Vascular Surgery
  • Interventional Cardiology

Background:

  • Percutaneous coronary intervention (PCI) commonly uses femoral arterial access.
  • Vascular closure devices (VCDs) are frequently employed to manage arterial access sites.
  • Complications related to femoral access, such as bleeding, are a concern.

Purpose of the Study:

  • To investigate the relationship between the height of femoral arterial puncture and access-site complications.
  • To evaluate the impact of vascular closure device (VCD) use on bleeding complications in relation to puncture site.
  • To analyze bleeding event differences based on common femoral artery (CFA), bifurcation, or lower puncture sites.

Main Methods:

  • A subgroup of the FERARI study involving femoral arterial access and pre-VCD inguinal angiography was analyzed.
  • Inguinal angiographies were reviewed by cardiologists to determine puncture height.
  • Bleeding complications within 30 days post-PCI were documented and categorized using BARC, TIMI, GUSTO, and FERARI classifications.

Main Results:

  • Common femoral artery (CFA) access occurred in 41%, bifurcation in 39%, and low puncture in 20% of patients.
  • No significant differences in PCI indications, procedural data, or anticoagulation were noted based on puncture height.
  • While CFA puncture showed numerically higher bleeding (62%) compared to bifurcation (41%), this was not statistically significant (p=0.059).

Conclusions:

  • Femoral arterial puncture height and the use of VCDs did not significantly influence bleeding complications after PCI.
  • No significant differences in bleeding events or other vascular endpoints were observed concerning puncture height.
  • The study suggests that puncture site location may not be a critical factor for bleeding risk when using VCDs in PCI.
Abstract

Keywords:
BleedingFemoral arteryVascular closure device

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