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Does micropuncture technique really help reduce vascular complications?

Hari Bogabathina1, Sampath Singireddy1, Runhua Shi1

  • 1Department of Medicine, Section of Cardiology, Louisiana State University Health Sciences Center, Shreveport, Shreveport, LA, United States.

Cardiovascular Revascularization Medicine : Including Molecular Interventions
|April 26, 2018
PubMed
Abstract

Insights

Micropuncture technique (MPT) did not reduce vascular complications (VCs) in femoral artery access cases. Vascular closure devices (VCDs) were found to be the only factor significantly lowering VC rates.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Vascular Surgery

Background:

  • Vascular complications (VCs) are a concern in cardiac catheterization procedures.
  • The micropuncture technique (MPT) is being adopted to mitigate these risks.
  • A quality improvement project was initiated to assess MPT's effectiveness in reducing VCs.

Purpose of the Study:

  • To evaluate the efficacy of the micropuncture technique (MPT) in reducing vascular complications (VCs) during femoral artery access.
  • To identify factors associated with a lower incidence of VCs in cardiac catheterization patients.

Main Methods:

  • A retrospective analysis of 647 non-STEMI femoral artery access cases was conducted.
  • Data from April-August 2016 (regular needle access) were compared to September 2016 onwards (MPT).
  • Vascular complications were defined by BARC criteria; MPT involved fluoroscopic marking of the femoral head without ultrasound guidance.

Main Results:

  • Micropuncture technique (MPT) did not significantly reduce VC rates compared to standard needle access (2.4% vs. 2.2%, p=1.0).
  • MPT utilization did not impact VC risk on univariate or multivariate analysis.
  • Vascular closure device (VCD) utilization was significantly associated with lower VC rates (OR 0.24, p=0.039).

Conclusions:

  • Micropuncture technique (MPT), without ultrasound guidance, did not statistically reduce vascular complications (VCs).
  • Vascular closure devices (VCDs) were the sole factor demonstrating a significant reduction in VCs.
  • Further large randomized studies are needed to confirm the routine benefit of MPT.
Keywords:
BleedingFemoral arteryHematomaVascular access complications

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