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Differences of bleedings after percutaneous coronary intervention using femoral closure and radial compression

Seung-Hyun Kim1, Michael Behnes1, Sebastian Baron1

  • 1First Department of Medicine, University Medical Centre Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg, European Center for AngioScience (ECAS), and DZHK (German Center for Cardiovascular Research) partner site Heidelberg/Mannheim, Mannheim, Germany.

Medicine
|May 18, 2019
PubMed

Insights

Femoral closure devices show higher bleeding rates after percutaneous coronary intervention compared to radial compression. Major adverse cardiac events remained similar between groups, suggesting radial access may reduce bleeding complications.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Vascular Access Management

Background:

  • Bleeding complications are a major concern following percutaneous coronary intervention (PCI).
  • Vascular closure devices (VCDs) are utilized to mitigate bleeding risks and improve patient outcomes.
  • Comparing specific femoral closure (FC) and radial compression (RC) devices is crucial for optimizing procedural safety.

Purpose of the Study:

  • To directly compare the efficacy and safety of a specific femoral closure (StarClose SE) versus a radial compression (TR Band) device post-PCI.
  • To evaluate differences in overall and access-site bleeding rates.
  • To assess major adverse cardiac events (MACE) at 30-day follow-up.

Main Methods:

  • A single-center, prospective, observational study enrolled 200 patients in each group (FC vs. RC) after PCI.
  • The primary outcome was bleeding complications.
  • Secondary outcomes included MACE at 30 days.

Main Results:

  • Access-site bleeding was significantly higher in the FC group (43%) compared to the RC group (30%) (P=.001).
  • Hematomas, including small and large sizes, were more frequent in the FC group.
  • No significant differences in MACE were observed between the FC and RC groups.

Conclusions:

  • Transfemoral arterial access, even with VCDs, is associated with higher access-site bleeding rates, primarily hematomas, compared to trans-radial access.
  • No significant difference in MACE was found between femoral closure and radial compression groups at 30-day follow-up.

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