Predictors of femoral hematoma in patients undergoing elective coronary procedure: a trigonometric evaluation

Vascular complications in the femoral artery puncture site are the most common complications of the coronary angiography. Femoral hematoma is the leading participant of the vascular complications. We investigated the femoral hematoma predictive value of angle of sheath to trochanter major in patients undergoing elective coronary procedures. In this prospective analysis, we evaluated the femoral hematoma predictive value of angle of sheath to trochanter major on 246 patients undergoing elective coronary procedures. In this prospective analysis, we evaluated the femoral hematoma predictive value of angle of sheath to trochanter major on 246 patients undergoing elective coronary procedures. Patients were divided into two as femoral hematoma (n = 23) and control (n = 223) groups according to post-procedure femoral hematoma status. Other independent predictors of femoral hematoma were also evaluated. In-hospital multivariable analysis revealed higher rates of femoral hematoma for patients with chronic renal failure (OR 24.97, 95% CI 3.04-78.88, p = 0.003), with higher diastolic blood pressure after the procedure (OR 1.08 95% CI 1.00-1.16, p = 0.037), with femoral vein puncture during procedure (OR 17.74, 95% CI 2.67-54.74, p = 0.003) and with higher angle of sheath to trochanter major (OR 1.52, 95% CI 1.13-2.05, p = 0.005). The best cut-off value of the angle of sheath to trochanter major to predict femoral hematoma was 15.6° with 74% sensitivity and 70% specificity (AUC: 0.75; 95% CI 0.63-0.86; p < 0.001). The angle of sheath to trochanter major provides an independent predictor of femoral hematoma in patients undergoing elective coronary procedures. Our data suggests the importance of fluoroscopic guidance during femoral artery access with the predictive role of the angle of sheath to trochanter major.