Access Site Complications After Peripheral Vascular Interventions: Incidence, Predictors, and Outcomes

Authors

• Daniel Ortiz, Aurora Health Care
• Arshad Jahangir, Aurora Health Care
• Maharaj Singh, Marquette UniversityFollow
• Suhail Allaqaband, University of Wisconsin School of Medicine and Public Health
• Tanvir Bajwa, University of Wisconsin School of Medicine and Public Health
• Mark W. Mewissen, Aurora Health Care

Document Type

Article

Publication Date

11-1-2014

Publisher

American Heart Association

Source Publication

Circulation: Cardiovascular Interventions

Source ISSN

1941-7640

Abstract

Background—

Access site hematomas and pseudoaneurysms are the most frequent complications of peripheral vascular intervention (PVI); however, their incidence and risk factors remain unclear.

Methods and Results—

We retrospectively analyzed data from the multicenter Vascular Quality Initiative on 22 226 patients who underwent 27 048 PVI from August 2007 to May 2013. Primary end points included incidence and predictors of access site complications (ASCs), length of postprocedural hospitalization, discharge status, and 30-day and 1-year mortality. ASC complicated 936 procedures (3.5%). Of these, 74.4% were minor complications, 9.7% were moderate requiring transfusion, 5.4% were moderate requiring thrombin injection, and 10.5% were severe requiring surgery. Predictors of ASC were age >75 years, female sex, white race, no prior PVI, nonfemoral arterial access site, >6-Fr sheath size, thrombolytics, arterial dissection, fluoroscopy time >30 minutes, nonuse of vascular closure device, bedridden preoperative ambulatory status, and urgent indication. Mean hospitalization was longer after procedures complicated by ASC (1.2±1.6 versus 1.9±1.9 days; range, 0–7 days; P=0.002). Severity of ASC correlated with higher rates of discharge to rehabilitation/nursing facilities compared with home discharge. Patients with severe ASC had higher 30-day mortality (6.1% versus 1.4%; P< 0.001), and those with moderate ASC requiring transfusion had elevated 1-year mortality (12.1% versus 5.7%; P< 0.001).

Conclusions—

Several factors independently predict ASC after PVI. Appropriate use of antithrombotic therapies and vascular closure device in patients at increased risk of ASC may improve post-PVI outcomes.

Comments

Accepted version. Circulation : Cardiovascular Interventions, Vol. 7, No. 6 (December 2014): 821-828. DOI. This article is © 2014 American Heart Association, Inc. Used with permission.

Maharaj Singh was affiliated with Aurora St. Luke's Medical Centers and Aurora University of Wisconsin Medical Group at the time of publication.

Recommended Citation

Ortiz, Daniel; Jahangir, Arshad; Singh, Maharaj; Allaqaband, Suhail; Bajwa, Tanvir; and Mewissen, Mark W., "Access Site Complications After Peripheral Vascular Interventions: Incidence, Predictors, and Outcomes" (2014). College of Nursing Faculty Research and Publications. 1228.
https://epublications.marquette.edu/nursing_fac/1228