TCT-221: Femoral Access Site Complication Rates After Percutaneous Coronary Intervention In 2517 Groin Punctures Undergoing Vascular Closure By Either Manual Compression Or the Perclose® Vascular Closure Device

AbstractVascular access site complications can follow diagnostic coronary and peripheral angiography. We compared the complication rates of the Catalyst vascular closure device, with the complication rates after manual compression in patients undergoing diagnostic angiographic procedures via femoral access. We studied 1,470 predominantly male patients undergoing diagnostic coronary and peripheral angiography. Catalyst closure devices were used in 436 (29.7%) patients and manual compression was used in 1,034 (70.3%) patients. The former were allowed to ambulate after 2 hours, while the latter were allowed to ambulate after 6 hours. Major complications occurred in 4 (0.9%) patients who had a Catalyst device and in 14 (1.4%) patients who had manual compression (odds ratio [OR]: 0.67, 95% confidence interval [CI]: 0.22–2.1, p = 0.49). Any complications occurred in 51 (11.7%) patients who had a Catalyst closure device and in 64 (6.2%) patients who had manual compression (OR: 2, CI: 1.4–3, p < 0.01). After adjustment for other variables and for a propensity score reflecting the probability to receive the closure device, the association of major complications with the use of the closure device remained not significant (OR: 0.54, 95% CI: 0.17–1.7, p = 0.29), while the association of any complications with the use of the Catalyst device remained significant (OR: 1.9, 95% CI: 1.3–2.9, p < 0.01). The Catalyst device was not associated with an increased risk of major groin complications but was associated with an increased risk of any complications compared with manual compression. Patients receiving the closure device ambulated sooner.

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Complex Large-Bore Radial percutaneous coronary intervention: rationale of the COLOR trial study protocol

BMJ Open ◽

10.1136/bmjopen-2020-038042 ◽

2020 ◽

Vol 10 (7) ◽

pp. e038042

Author(s):

Thomas A Meijers ◽

Adel Aminian ◽

Koen Teeuwen ◽

Marleen van Wely ◽

Thomas Schmitz ◽

...

Keyword(s):

Percutaneous Coronary Intervention ◽

Vascular Complications ◽

Coronary Intervention ◽

Ethics Committee ◽

Bleeding Complications ◽

Access Site ◽

Femoral Access ◽

Coronary Syndrome ◽

Percutaneous Coronary ◽

Coronary Lesions

IntroductionThe radial artery has become the standard access site for percutaneous coronary intervention (PCI) in stable coronary artery disease and acute coronary syndrome, because of less access site related bleeding complications. Patients with complex coronary lesions are under-represented in randomised trials comparing radial with femoral access with regard to safety and efficacy. The femoral artery is currently the most applied access site in patients with complex coronary lesions, especially when large bore guiding catheters are required. With slender technology, transradial PCI may be increasingly applied in patients with complex coronary lesions when large bore guiding catheters are mandatory and might be a safer alternative as compared with the transfemoral approach.Methods and analysisA total of 388 patients undergoing complex PCI will be randomised to radial 7 French access with Terumo Glidesheath Slender (Terumo, Japan) or femoral 7 French access as comparator. The primary outcome is the incidence of the composite end point of clinically relevant access site related bleeding and/or vascular complications requiring intervention. Procedural success and major adverse cardiovascular events up to 1 month will also be compared between both groups.Ethics and disseminationEthical approval for the study was granted by the local Ethics Committee at each recruiting center (‘Medisch Ethische Toetsing Commissie Isala Zwolle’, ‘Commissie voor medische ethiek ZNA’, ‘Comité Medische Ethiek Ziekenhuis Oost-Limburg’, ‘Comité d’éthique CHU-Charleroi-ISPPC’, ‘Commission cantonale d'éthique de la recherche CCER-Republique et Canton de Geneve’, ‘Ethik Kommission de Ärztekammer Nordrhein’ and ‘Riverside Research Ethics Committee’). The trial outcomes will be published in peer-reviewed journals of the concerned literature.Trial registration numberNCT03846752.

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LONG TERM OUTCOMES ASSOCIATED WITH VASCULAR CLOSURE DEVICE USE IN PATIENTS UNDERGOING PERCUTANEOUS CORONARY INTERVENTION VIA THE FEMORAL APPROACH: A PROPENSITY SCORE ADJUSTED, PROPENSITY SCORE MATCHED ANALYSIS

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(10)62036-0 ◽

2010 ◽

Vol 55 (10) ◽

pp. A215.E2035

Author(s):

Sripal Bangalore ◽

Venkatesan Vidi ◽

Frederick G. Welt ◽

Pinak B. Shah ◽

Frederic Resnic

Keyword(s):

Percutaneous Coronary Intervention ◽

Propensity Score ◽

Coronary Intervention ◽

Closure Device ◽

Long Term Outcomes ◽

Vascular Closure Device ◽

Femoral Approach ◽

Percutaneous Coronary ◽

Device Use

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Nursing interventions to decrease bleeding at the femoral access site after percutaneous coronary intervention

American Journal of Critical Care ◽

10.4037/ajcc2000.9.1.79 ◽

2000 ◽

Vol 9 (1) ◽

pp. 79-79

Author(s):

RA Krouscoup

Keyword(s):

Percutaneous Coronary Intervention ◽

Coronary Intervention ◽

Nursing Interventions ◽

Access Site ◽

Femoral Access ◽

Percutaneous Coronary

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Comparison of Radial and Femoral Percutaneous Coronary Intervention

Journal of Nepal Health Research Council ◽

10.33314/jnhrc.v18i3.2587 ◽

2020 ◽

Vol 18 (3) ◽

pp. 366-372

Author(s):

Mahesh Bhattarai ◽

Arun Maskey ◽

Ram Kishore Shah ◽

Buna Bhandari ◽

Chandramani Adhikari ◽

...

Keyword(s):

Percutaneous Coronary Intervention ◽

Coronary Intervention ◽

Target Lesion ◽

Access Site ◽

Femoral Access ◽

Radial Approach ◽

Radial Access ◽

Clinical Events ◽

Percutaneous Coronary ◽

Heart Center

Background: The use of radial access for percutaneous coronary intervention is increasing in Nepal. However, there is limited study on the comparison of radial and femoral access in Nepal. This is the study comparing net adverse clinical events of radial with femoral access for intervention. Methods: This prospective study was conducted at Shahid Gangalal National Heart Center from January 2014 to June 2015 among 849 participations who underwent percutaneous coronary interventions, and 418 radial interventions were compared with 418 femoral interventions. A comparison was done in terms of 30- day rate of net adverse clinical events defined as the composite of death, myocardial infarction, stroke, target lesion revascularization and major bleeding. Results: Incidence of net adverse clinical events was significantly lower in radial compared to femoral approach 18(4.30%) vs. 51 (12.2%), p= <0.001). Mortality observed in the radial approach was significantly lower (p=<0.001) compared to femoral. Procedure success was not significantly different p=0.629. The trans-radial approach had significantly higher crossover rate (p=0.001). Observed vascular access site complications (p=0.026) and hospital stay (p=<0.0001) were lower in the radial group. Radiation exposure measured by fluoroscopy exposure time was not significantly different between the two groups (p=0.290). Conclusions: Radial access is associated with a lower rate of net adverse clinical events at 30 days compared to femoral access. Radial access is safer and equally effective compared to femoral access in the context of Nepal. Keywords: Femoral; percutaneous coronary intervention; radial

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