Association Between Sub-bandage Pressure and Femoral Artery Puncture Complications and Determinants of Initial...

This study was designed to assess associations between real-time sub-bandage pressure patterns and puncture-related complications after femoral artery puncture and explore determinants of initial compression effectiveness.

This was a prospective study enrolling adults scheduled for transfemoral cerebral angiography. All participants were followed from the time of vascular access closure through the immediate post-procedural period.

A novel miniature pressure sensor was adopted to continuously monitor the sub-bandage pressure after the procedure and pressure measurements were obtained at pre-set intervals in the complication (n=20) and the non-complication (n=182) groups.Regression analyses were performed to identify predictors of initial-to-occlusion pressure ratio.

Patients with complications exhibited significantly higher initial bandaging pressure (median 6.1 N, IQR 4.4-7.9 N; p=0.045) and faster pressure attenuation in the first 0.5 h post-procedure (2.6N/h; p=0.018). The initial-to-occlusion pressure ratio was not significantly different between groups (z= -0.733, p=0.463). Pressure-time trajectories showed the greatest decline during the first 2 h, indicating a high-risk period for bandage loosening/displacement. Regression analysis indicated that systolic blood pressure, body habitus, and age were independent predictors for the initial-to-occlusion pressure ratio (p<0.05).

Continuous real-time sub-bandage pressure monitoring indicates that elastic bandages provide effective initial bandaging following transfemoral cerebral angiography, but a rapid decline in pressure is associated with increased puncture-related complications. Compression should be individualized by systolic blood pressure, body habitus, and age.