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Impact of Sex on Outcomes With Femoral Artery Closure Devices Versus Manual Compression in Patients Undergoing

Wesley L Anderson1, Asad J Torabi1, Brian A O'leary1

  • 1Department of Medicine, Division of Cardiovascular Medicine Indiana University School of Medicine Indianapolis Indiana USA.

Health Science Reports
|December 20, 2024
PubMed

Insights

Women benefit more from femoral artery closure devices (VCD) after percutaneous coronary interventions (PCI). VCD reduce bleeding, hematoma, and vascular complications, especially in women undergoing PCI via femoral access.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Vascular Surgery

Background:

  • Femoral artery access remains common for percutaneous coronary interventions (PCI), necessitating effective vascular closure.
  • Vascular closure devices (VCD) aim to reduce closure time and bleeding complications.
  • Sex-based differences in outcomes following femoral artery closure require investigation.

Purpose of the Study:

  • To evaluate sex-specific outcomes associated with femoral artery vascular closure devices (VCD) in patients undergoing PCI.
  • To compare the efficacy and safety of VCD versus manual compression in men and women.

Main Methods:

  • Retrospective analysis of 11,415 patients undergoing PCI with femoral artery access from the Indiana University Health Multicenter Cardiac Cath registry.
  • Comparison of clinical outcomes between VCD and manual compression, stratified by sex.
  • Exclusion of patients with cardiogenic shock or left ventricular support devices.

Main Results:

  • VCD use was associated with a significant reduction in 72-hour bleeding events compared to manual compression (aOR: 0.64; 95% CI: 0.46-0.87).
  • Women experienced higher rates of 72-hour bleeding with manual compression (4.5% vs. 1.6% in men).
  • Women showed a greater absolute risk reduction in bleeding with VCD (2.8% vs. 0.8% in men), along with lower risks of access site bleeding, hematoma, and vascular complications. VCD use also reduced in-hospital death risk (aOR: 0.4; 95% CI: 0.28-0.58).

Conclusions:

  • Women derive greater benefits from femoral artery VCD during PCI compared to men.
  • VCD significantly decrease bleeding rates, access site hematoma, and vascular complications in women undergoing PCI.
  • The findings support the use of VCD in women undergoing PCI via femoral access to improve safety outcomes.
Abstract

Keywords:
bleedingcardiac catheterizationpercutaneous coronary intervention, sex, women, vascular closure devices

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