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Predictors of groin complications after balloon and new-device coronary intervention

R Waksman1, S B King, J S Douglas

  • 1Andreas Gruentzig Cardiovascular Center, Emory University Hospital, Atlanta, Georgia 30322, USA.

The American Journal of Cardiology
|May 1, 1995
PubMed

Insights

Vascular complications occurred in 6.1% of patients undergoing percutaneous transluminal coronary angioplasty (PTCA). Older age, female gender, and intracoronary stenting were linked to increased complication rates.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Vascular Surgery

Background:

  • Percutaneous transluminal coronary angioplasty (PTCA) is a common procedure for coronary artery disease.
  • Vascular complications at the access site are a known risk of PTCA.
  • Newer devices are increasingly used in PTCA, necessitating an understanding of their associated complication rates.

Purpose of the Study:

  • To evaluate the incidence and correlates of vascular complications in patients undergoing PTCA.
  • To compare complication rates between balloon angioplasty and new devices, including stents, lasers, and atherectomy.
  • To identify patient and procedural factors associated with vascular complications requiring intervention.

Main Methods:

  • Retrospective review of 5,042 patients undergoing PTCA with balloons or new devices (stent, laser, directional/rotational atherectomy).
  • Vascular complications defined as groin hematoma, bleeding, pseudoaneurysm, fistula, or need for surgical repair.
  • Statistical analysis to identify correlates of vascular complications.

Main Results:

  • Vascular complications occurred in 6.1% of patients (309/5042), with 2.3% (117/5042) requiring vascular repair.
  • Pseudoaneurysm repair (72%) was the most common intervention.
  • Correlates of complications included older age, female gender, higher weight, higher systolic blood pressure, increased heparin dose, and intracoronary stenting (14.9% vs 3.5%).

Conclusions:

  • Vascular complications are a significant concern in PTCA, particularly with intracoronary stenting.
  • Patient factors like age and gender, along with procedural anticoagulation, are associated with increased risk.
  • The use of devices other than stents did not increase the rate of vascular complications.

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