Vascular Access-Related Complications in Women: Temporal Trends, Emerging Data, and the Current State of...

Area of Science:

• Cardiology
• Vascular Surgery
• Interventional Cardiology

Background:

• Women undergoing structural heart interventions experience higher rates of vascular complications and bleeding compared to men.
• These complications contribute to significant morbidity and mortality in the female population.

Purpose of the Study:

• To highlight female sex as an independent risk factor in cardiac interventions.
• To explore the mechanisms underlying increased risk in women.
• To present strategies for minimizing vascular complications and bleeding in women.

Main Methods:

• This review synthesizes current literature on sex-based differences in procedural risk.
• It examines physiological and pharmacological factors contributing to increased risk in women.
• It evaluates the efficacy of risk-mitigation strategies.

Main Results:

• Key risk factors in women include smaller vessel size, lower body weight, and altered platelet reactivity.
• Inappropriate dosing of anticoagulant and antiplatelet medications further elevates risk.
• Strategies such as radial artery access, smaller sheath utilization, and image-guided puncture reduce complications.

Conclusions:

• Female sex is a critical, independent risk factor for vascular complications and bleeding in cardiac interventions.
• Implementing sex-specific risk assessment and tailored procedural techniques is essential.
• Operator proficiency in strategies like radial access and adjusted anticoagulation is crucial for improving outcomes in women.