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Vascular Access in Percutaneous Coronary Intervention of Chronic Total Occlusions: A State-of-the-Art Review

Thomas A Meijers1, Adel Aminian2, Marco Valgimigli3

  • 1Department of Cardiology, Isala Heart Center, Zwolle, the Netherlands (T.A.M., M.A.H.v.L.).

Circulation. Cardiovascular Interventions
|July 17, 2023
PubMed

Insights

Vascular access site bleeding is a common complication during chronic total occlusion percutaneous coronary intervention. This review covers current evidence on optimal vascular access strategies to improve procedural safety and reduce bleeding events.

Area of Science:

  • Interventional Cardiology
  • Vascular Access Management

Background:

  • Chronic total occlusion percutaneous coronary intervention (CTO-PCI) outcomes have improved, but procedural safety, particularly access site bleeding, remains a challenge.
  • Vascular access site complications are frequent and can impact patient recovery and procedural success.

Purpose of the Study:

  • To review and synthesize current evidence on optimal vascular access strategies for CTO-PCI.
  • To provide guidance on minimizing vascular access site complications during CTO-PCI.

Main Methods:

  • State-of-the-art literature review.
  • Synthesis of current evidence on vascular access techniques and management in CTO-PCI.

Main Results:

  • Multiple strategies exist to reduce vascular access site bleeding.
  • Optimal strategies involve careful selection of access site, closure devices, and anticoagulation management.

Conclusions:

  • Implementing evidence-based vascular access strategies is crucial for enhancing safety in CTO-PCI.
  • Further research may refine best practices for access site management in complex PCI procedures.

Keywords:
consensushemorrhagepercutaneous coronary interventionvascular diseases

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