Special attention should be given to identify access site related complications in percutaneous intervention procedures performed within radiology, cardiology and vascular surgery. Femoral arterial access is the most widely used approach for diagnostic with an overall complication rate reported up to 1.9% [1-2]. The minimal invasive femoral approach with its associated complications affect morbidity, mortality and health care cost [3-4]. The association between major complications and various demographic and procedural characteristics have been investigated [1-2,5-7]. The aim of this study was to describe the incidence...

This retrospective study includes 23,870 index procedures performed in two centers, from January 2006 to October 2012. We collected demographic, procedural and mortality data obtained from the Eastern Danish Heart Registry. Data were cross-matched with information from the Danish Vascular Registry on vascular access complications requiring surgical intervention within 30 days after the intervention. An index procedure was defined as any first time a patient had an acute or elective trans-femoral coronary angiography eventually combined with percutaneous coronary intervention. Statistics: Logistic regression analyses were used...

Indications for percutaneous intervention were ST-segment elevation myocardial infarction in 4,739 (20%) and Non-ST-segment elevation myocardial infarction or unstable angina in 7,022 (30%). A majority of the procedures were coronary angiography but 8,367 (35%) had an additional percutaneous coronary intervention performed. The puncture sites were closed by either manual compression 3,372 (14%) or vascular closure device 20,498 (86%). During the study period 130 patients (0.54%) experienced major femoral vascular access complications requiring surgical intervention: 65 pseudoaneurysms (0.28%) (Fig. 1), 46 arterial occlusions (0.19%) (Fig. 2),...

Our study demonstrated a low incidence of major femoral vascular access complications following coronary angiography and percutaneous intervention (0.54%). Factors for increased risk of major complications were identified as female gender, atherosclerotic disease, and the necessity to switch access side to left or use of both femoral arteries instead of the default right sided approach.

D. Dencker, MD at the Department of Radiology Copenhagen University Hospital

1. Gurm HS, Hosman C, Share D, Moscucci M, Hansen BB, Blue Cross Blue Shield of Michigan Cardiovascular Consortium. Comparative safety of vascular closure devices and manual closure among patients having percutaneous coronary intervention. Ann Intern Med. 2013 Nov 19;159(10):660–6. 2. Smilowitz NR, Kirtane AJ, Guiry M, Gray WA, Dolcimascolo P, Querijero M, et al. Practices and complications of vascular closure devices and manual compression in patients undergoing elective transfemoral coronary procedures. Am J Cardiol. 2012 Jul 15;110(2):177–82. 3. Mamas MA, Ratib K, Routledge H,...