Vascular Access-Site Complications in Chronic Total Occlusion Percutaneous Coronary Intervention.

IF 2.1 3区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Catheterization and Cardiovascular Interventions Pub Date : 2025-03-17 DOI:10.1002/ccd.31501

Michaella Alexandrou, Dimitrios Strepkos, Pedro E P Carvalho, Deniz Mutlu, Ozgur Selim Ser, Khaldoon Alaswad, Mir B Basir, Dmitrii Khelimskii, Oleg Krestyaninov, Jaikirshan J Khatri, Laura Young, Omer Goktekin, Paul Poommipanit, Farouc A Jaffer, Sevket Gorgulu, Lorenzo Azzalini, Ramazan Ozdemir, Mahmut Uluganyan, Leah M Raj, Olga Mastrodemos, JaskanwalDeep S Sara, Bavana V Rangan, Sandeep Jalli, Konstantinos V Voudris, Yader Sandoval, M Nicholas Burke, Emmanouil S Brilakis

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引用次数: 0

Abstract

Background: Vascular access-site complications (VASC) can occur during chronic total occlusion (CTO) percutaneous coronary intervention (PCI).

Methods: We compared the baseline and procedural characteristics, and outcomes of patients with versus without VASC in a large multicenter CTO PCI registry. VASC was defined as any of the following: small hematoma (hematoma < 5 cm), large hematoma (hematoma ≥ 5 cm), arteriovenous fistula, pseudoaneurysm and acute arterial closure.

Results: VASC occurred in 158 of 16,810 CTO PCIs (0.9%). VASC patients were older (67 ± 11 vs. 64 ± 10 years, p < 0.001), more likely to be women (28.4% vs. 19.1%, p = 0.004) and less likely to be current smokers (18.9% vs. 27.2%, p = 0.026). They were more likely to have at least one femoral access (89.2% vs. 75.3%, p < 0.001) and less likely to have any radial access (38.0% vs. 52.3%, p < 0.001). Transfemoral access was more common in patients with VASC (60.1% vs. 45.7%, p < 0.001). VASC cases had higher J-CTO (2.57 vs. 2.38, p = 0.05) and PROGRESS-CTO major adverse cardiac events (MACE) scores (3.27 vs. 2.58, p < 0.001). They had similar technical (87.3% vs. 87.1%, p > 0.9) and procedural (82.3% vs. 85.9%, p = 0.2) success, but higher MACE (6.3% vs. 1.9%, p < 0.001) and bleeding (23.4% vs. 0.4%, p < 0.001). Female gender (odds ratio [OR] 1.95, 95% confidence intervals [CI] 1.24-3.00, p = 0.003), at least one femoral access (OR 2.02, 95% CI 1.09-4.04, p = 0.034) and sheath size (7-F: OR 2.16, 95% CI 1.12-4.60, p = 0.031; 8-F: OR 2.11, 95% CI 1.03-4.70,p = 0.051) were associated with VASC in multivariable analysis.

Conclusion: Female sex, femoral access and larger sheaths ≥ 7 F were associated with VASC in patients undergoing CTO PCI.

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来源期刊

Catheterization and Cardiovascular Interventions 医学-心血管系统

CiteScore

5.40

自引率

8.70%

发文量

419

审稿时长

2 months

期刊介绍： Catheterization and Cardiovascular Interventions is an international journal covering the broad field of cardiovascular diseases. Subject material includes basic and clinical information that is derived from or related to invasive and interventional coronary or peripheral vascular techniques. The journal focuses on material that will be of immediate practical value to physicians providing patient care in the clinical laboratory setting. To accomplish this, the journal publishes Preliminary Reports and Work In Progress articles that complement the traditional Original Studies, Case Reports, and Comprehensive Reviews. Perspective and insight concerning controversial subjects and evolving technologies are provided regularly through Editorial Commentaries furnished by members of the Editorial Board and other experts. Articles are subject to double-blind peer review and complete editorial evaluation prior to any decision regarding acceptability.