Incidence and Predictors of Post-catheterisation Femoral Artery Access Vascular Complication in North Indian Population

Introduction: Vascular access-site complications following percutaneous interventions done using femoral approach, are an important cause of mortality, morbidity, prolonged stay and greater cost burden. Aim: To study the incidence and the factors which predict femoral artery access vascular complication after catheterisation in North Indian population. Materials and Methods: This was a prospective longitudinal observational study conducted at Department of Cardiology SMS Medical College at Jaipur, Rajasthan ,India between April 2016 to November 2017. All patients (n=11200) who underwent catheterisation from the femoral approach from April 2016 till November 2017 in the study institute were included. Duplex ultrasound was performed in cases with clinical suspicion of vascular complications. Clinical data and procedural variables were compared with a control group of 100 randomly selected patients. Univariate analysis and a logistic regression model for multivariate analysis for predicting independent variable was performed. Results: Femoral artery access vascular complication incidence rate was 2.05% (230). Complications rate was higher for interventional procedures (3.6%) than diagnostic procedures (1.25%). The most common vascular complication was haematoma which was seen in 1.29% (145) patients, other complication were femoral artery venous fistula seen in 0.37% (42) patients, pseudo-aneurysm in 0.41% (46) patients, acute limb ischemia in 0.1% (12) and infection in 0.09% (11) patients. It was found that advanced age (>60 years), female gender, obesity and hypertension were predictors of complication. Patients who received thrombolytic agent or low molecular weight heparin prior to procedure, use of large sheath size (7F v/s 6F) and multiple puncture to achieve femoral artery access were also independent predictors of vascular complication. Diabetes mellitus and duration of manual compression had no impact on vascular complication. Conclusion: Femoral artery access vascular complication is not uncommon following diagnostic or interventional cardiac catheterisation. The strongest predictors of vascular complication were advanced age (>60 year), female gender, overweight & obesity, hypertension, use of thrombolytic agent or anticoagulant prior to procedure, large size sheath 7F, and multiple puncture. Use of smaller sheaths, improved access techniques, safer antithrombotic therapy and use of vascular closure devices may be helpful for prevention of these vascular complications.

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Acute Complication Due to Impella 2.5 Device (Superficial Femoral Artery Thrombosis): Managed Successfully with Novel Aspiration Thrombectomy catheter (pronto V3)

Clinical Medicine Insights Cardiology ◽

10.4137/cmc.s6157 ◽

2011 ◽

Vol 5 ◽

pp. CMC.S6157 ◽

Cited By ~ 6

Author(s):

Tariq M. Bhat ◽

Alain Waked ◽

Sumaya Teli ◽

James Lafferty ◽

Bhavesh Gala

Keyword(s):

High Risk ◽

Femoral Artery ◽

Superficial Femoral Artery ◽

Thrombus Formation ◽

Vascular Complications ◽

Coronary Intervention ◽

Left Ventricular ◽

Vascular Complication ◽

Aspiration Thrombectomy ◽

First Case

The Impella recover LP 2.5 is a percutaneous left ventricular assist device (LVAD) recently approved for use in patients undergoing high risk percutaneous coronary intervention (PCI) and also in cases of cardiogenic shock. There is limited evidence available in literature about its safety, especially with regards to the incidence of local vascular complications, their management and long-term implications. We report here the first case of a serious local vascular complication—superficial femoral artery thrombus formation during Impella recover LP 2.5 use in a high risk PCI which was managed successfully with novel aspiration thrombectomy catheter (Pronto V3), which in itself is the first reported use of Pronto V3 in such a vascular complication.

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Anatomical study of the variations in the origin of the lateral circumflex femoral artery in north Indian population

Journal of Anatomical Society of India ◽

10.1016/j.jasi.2016.08.161 ◽

2016 ◽

Vol 65 ◽

pp. S49

Author(s):

Neha Rai ◽

A. Jain ◽

P. Rana

Keyword(s):

Femoral Artery ◽

Indian Population ◽

Anatomical Study ◽

North Indian Population ◽

Lateral Circumflex Femoral Artery ◽

Circumflex Femoral Artery ◽

Lateral Circumflex Femoral

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Abstract #251: Prevalence of Vitamin D Deficiency in Type 2 Diabetes Patients in North Indian Population and its Correlation with Diabetic Complications and Comorbidities

Endocrine Practice ◽

10.1016/s1530-891x(20)44959-6 ◽

2016 ◽

Vol 22 ◽

pp. 56-57

Author(s):

Brij Makkar ◽

Namrata Harichandan ◽

Jugal Sharma ◽

Rajeev Chawla ◽

Shalini Jaggi ◽

...

Keyword(s):

Type 2 Diabetes ◽

Vitamin D ◽

Vitamin D Deficiency ◽

Diabetic Complications ◽

Indian Population ◽

North Indian Population ◽

Diabetes Patients

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Use of vascular closure devices for endovascular interventions requiring a direct puncture of PETE grafts

VASA ◽

10.1024/0301-1526/a000677 ◽

2018 ◽

Vol 47 (2) ◽

pp. 119-124 ◽

Cited By ~ 2

Author(s):

Artur I. Milnerowicz ◽

Aleksandra A. Milnerowicz ◽

Marcin Protasiewicz ◽

Wiktor Kuliczkowski

Keyword(s):

Statistical Significance ◽

Vascular Complications ◽

Vascular Complication ◽

Inguinal Region ◽

Closure Device ◽

Manual Compression ◽

Direct Puncture ◽

Endovascular Interventions ◽

Vascular Closure Devices ◽

Closure Group

Abstract. Background: Effectiveness of vascular closure devices during endovascular procedures requiring a direct puncture of a vascular prosthesis placed in the inguinal region is unknown. Patients and methods: The retrospective analysis included 134 patients with a history of polyethylene terephthalate (PETE) graft implantation in the inguinal region. In 20 (15 %) patients, haemostasis was achieved with manual compression, in 21 (16 %) with the StarClose™, and in 93 (69 %) with the AngioSeal™ device. Results: The incidence of vascular complications in the manual compression group was higher (at a threshold of statistical significance) than in the device closure group (45.0 vs. 24.5 %, p = 0.059). The difference was considered statistically significant when manual compression was compared with the AngioSeal™ closure group (45.0 vs. 13.9 %, p < 0.01). The vascular complication rate in the StarClose™ group was significantly higher than in the AngioSeal™ group (71.4 vs. 13.9 %, p < 0.000001). While haematomas were the only vascular complications observed after application of AngioSeal™, both haematomas and pseudoaneurysms were found in the StarClose™ group. Conclusions: The AngioSeal™ vascular closure device provides better local haemostasis than the StarClose™ device or manual compression during endovascular interventions requiring a direct puncture of PETE grafts

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Influence of impacted mandibular third molar on angle fracture: a retrospective study among north Indian population

European Journal of Oral and Maxillofacial Surgery ◽

10.23736/s2532-3466.19.00179-6 ◽

2019 ◽

Vol 3 (3) ◽

Author(s):

Pradeep Sharma ◽

Amit Kumar ◽

Vidhi C. Rathi ◽

Rajarshi Ghosh ◽

Lily Rajput ◽

...

Keyword(s):

Retrospective Study ◽

Indian Population ◽

Third Molar ◽

North Indian Population ◽

Impacted Mandibular Third Molar ◽

Mandibular Third Molar ◽

Angle Fracture

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Morphological Study of the Menisci of the Knee Joint in Adult Cadavers of North Indian Population

International Journal of Life-Sciences Scientific Research ◽

10.21276/ijlssr.2016.2.5.19 ◽

2016 ◽

Vol 2 (5) ◽

Author(s):

Dr. M Yousuf Sarwar ◽

Dr. Nilesh Kumar ◽

Dr. Tarannum Yasmin

Keyword(s):

Knee Joint ◽

Morphological Study ◽

Indian Population ◽

North Indian Population

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IL-10(-592A/C) gene variant a predictor of postoperative atrial fibrillation in the north Indian population

Journal of Arrhythmia ◽

10.1002/joa3.12074 ◽

2018 ◽

Vol 34 (3) ◽

pp. 281-285 ◽

Cited By ~ 1

Author(s):

Surabhi Yadav ◽

Salman Akhtar ◽

Surendra K. Agarwal ◽

Gauranga Majumdar ◽

Suman Vimal ◽

...

Keyword(s):

Atrial Fibrillation ◽

Indian Population ◽

Postoperative Atrial Fibrillation ◽

Gene Variant ◽

North Indian Population ◽

The North

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Standardized Measurement of Femoral Artery Depth by Computed Tomography to Predict Vascular Complications After Transcatheter Aortic Valve Implantation

The American Journal of Cardiology ◽

10.1016/j.amjcard.2020.12.089 ◽

2021 ◽

Author(s):

Eric Durand ◽

Maryline Penso ◽

Thibault Hemery ◽

Thomas Levesque ◽

Gustavo Moles ◽

...

Keyword(s):

Computed Tomography ◽

Aortic Valve ◽

Transcatheter Aortic Valve Implantation ◽

Femoral Artery ◽

Vascular Complications ◽

Transcatheter Aortic Valve ◽

Standardized Measurement ◽

Aortic Valve Implantation ◽

Valve Implantation

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Complete percutaneous angio-guided implantation and explantation of VA-ECMO using preclosing for cardiogenic shock or cardiac arrest

European Heart Journal Acute Cardiovascular Care ◽

10.1093/ehjacc/zuab020.209 ◽

2021 ◽

Vol 10 (Supplement_1) ◽

Author(s):

R Gallet ◽

AS Martin-Tuffreau ◽

F Bagate ◽

M Boukantar ◽

G Saiydoun ◽

...

Keyword(s):

Cardiac Arrest ◽

Cardiogenic Shock ◽

Vascular Complications ◽

Vascular Complication ◽

Vascular Intervention ◽

Technical Success Rate ◽

Surgical Closure ◽

Refractory Cardiogenic Shock ◽

Distal Perfusion ◽

Va Ecmo

Abstract Funding Acknowledgements Type of funding sources: None. Background. The approach for veno-arterial extracorporeal membrane oxygenation implantation (VA-ECMO) in patients with cardiogenic shock can be either surgical or percutaneous. Angio-guided percutaneous implantation and explantation could decrease vascular complications. Purpose We sought to describe the feasibility and safety of complete percutaneous angio-guided ECMO implantation and explantation using preclosing. Methods. All consecutive patients who underwent peripheral femoro-femoral VA-ECMO percutaneous implantation for refractory cardiogenic shock or cardiac arrest were enrolled in a prospective registry (03/2018-09/2020). Percutaneous preclosing using two closing devices (Perclose ProGlide, Abbott) inserted before cannulation was used in both femoral artery and vein. Explantation was performed using a crossover technique under fluoroscopic guidance. The occurrence of vascular complication was recorded. Results. Forty-nine patients underwent percutaneous VA-ECMO implantation for cardiogenic shock (n = 36) or refractory cardiac arrest (n = 13). Femoral vessel cannulations were successful in all patients and total cannulation time was 21± 8 min. Weaning from ECMO was possible in 23 patients (47%) and 11 (22%) patients were alive at 30-day. Significant vascular complications occurred in 3 patients (6%); all were related to distal perfusion line. One patient experienced major bleeding, and 2 experienced lower limb ischemia requiring vascular intervention (one failure of distal perfusion sheath implantation and one self-uprooting of the reperfusion cannula). Percutaneous decannulation was performed in 17 patients with 16/17 technical success rate. All femoral arteries and veins were properly closed using the pre-closing devices without bleeding on the angiographic control except for one patient in whom surgical closure of the artery was required. Among these patients, none required transfusion for access related significant bleeding and no other vascular complication occurred. Furthermore, no groin infection was observed after full percutaneous implantation and removal of ECMO. Conclusion. Emergent complete percutaneous angio-guided VA-ECMO implantation and explantation using pre-closing technique is an effective and safe strategy in patients referred for refractory cardiogenic shock or cardiac arrest.

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