Related Experiment Videos
[Incidence of peripheral vascular complications in subjects undergoing coronary angioplasty]
A S Petronio1, G Amoroso, U Limbruno
1Istituto di Cardiologia, Università degli Studi, Pisa.
Insights
Early removal of the arterial sheath after percutaneous transluminal coronary angioplasty (PTCA) significantly reduces peripheral vascular complications. This practice also shortens the hospital stay for patients undergoing cardiac catheterization.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Vascular Surgery
Context:
- Increasing incidence of peripheral vascular complications following cardiac catheterization.
- Femoral arterial access is common for percutaneous transluminal coronary angioplasty (PTCA).
- Arterial sheath management is a critical factor in post-procedure care.
Purpose:
- To evaluate the impact of early arterial sheath removal on reducing vascular complications after PTCA.
- To compare complication rates between early and delayed sheath removal strategies.
- To identify risk factors associated with vascular complications.
Summary:
- A study of 451 patients undergoing PTCA via femoral approach compared early (immediate) versus delayed (12-14 hours) arterial sheath removal.
- Vascular complications occurred in 16 patients (11 in the delayed group, 5 in the early group).
- Iliacofemoral atherosclerotic disease and complex procedures were associated with increased complications; early sheath removal reduced overall complications and hospital stay.
Impact:
- Early arterial sheath removal is a key strategy to minimize post-catheterization vascular complications.
- Optimizing sheath removal timing can improve patient outcomes and reduce healthcare resource utilization.
- Findings support the adoption of early sheath removal protocols in interventional cardiology.
Abstract:
The peripheral vascular complications following cardiac catheterization for interventional procedures are increasing. The aim of our study is to evaluate the importance of the early removal of the arterial sheath in reducing vascular complications. We examined 451 consecutive patients, submitted to percutaneous transluminal coronary angioplasty (PTCA) by femoral approach. In 229 patients (Group A), we removed the arterial sheath 12-14 hours after PTCA; in 222 patients (Group B) the arterial sheath was removed as soon as possible at the end of PTCA. In 31 Group A and 5 Group B patients we performed a coronarographic study after 12-14 hours. In total, 16 patients (11 Group A, 5 Group B) presented vascular complications. None of the risk factors that we have considered was predictive for complications, except that iliacofemoral atherosclerotic disease. In patients undergoing complex procedures we have found a greater amount of vascular complications. The coronarographic control revealed some pathologic lesion (dissection, occlusive thrombus) only in patients with clear ischemic signs or symptoms, both in Group A and B. In our opinion, an early removal of the arterial sheath reduces the incidence of vascular complications and the period of in-hospital stay.