Predictors of groin complications after balloon and new-device coronary intervention

Am J Cardiol. 1995 May 1;75(14):886-9. doi: 10.1016/s0002-9149(99)80681-x.

Abstract

We reviewed the clinical course of 5,042 patients who underwent percutaneous transluminal coronary angioplasty (PTCA) using balloons or new devices: (stent, laser, directional and rotational atherectomy). A vascular complication was defined as the formation of a groin hematoma, bleeding, pseudoaneurysm, fistula, or the need for surgical repair. Vascular complications occurred in 309 (6.1%) patients, and 117 (2.3%) required vascular repair; among these patients, surgery was performed for correction of an an arteriovenous fistula in 12%, repair of pseudoaneurysm in 72%, repair for expanding hematoma and femoral artery lacerations in 10%, and retroperitoneal bleeding in 6%. The correlates of vascular complications were older age (66.8 vs 62.1 years; p < 0.0001), female gender (43% vs 26%; p < 0.0001), increased weight (82.1 +/- 16.46 vs 78.0 +/- 16.6 kg; p < 0.001), higher systolic blood pressure (140 +/- 25 vs 134 +/- 20 mm Hg; p < 0.001), increased heparin dose during the procedure (14,352 +/- 3,879 vs 13,599 +/- 3,508 IU; p = 0.001), administration of heparin after the procedure (232 vs 2,985 patients; p < 0.0001) and intracoronary stenting (14.9% vs 3.5%; p < 0.0001). Fifteen patients of 214 (7.0%) who underwent stent implantation had surgical repair. Vascular complications were not related to the size of the arterial sheath (8.11 +/- 0.8 vs 8.8 +/- 0.7Fr; p = 0.11) and the use of devices other than stents (laser, atherectomy) did not increase the rate of vascular complications.

MeSH terms

  • Aged
  • Aneurysm / etiology
  • Aneurysm / surgery
  • Angioplasty / adverse effects*
  • Angioplasty / instrumentation
  • Angioplasty, Balloon, Coronary / adverse effects
  • Angioplasty, Laser / adverse effects
  • Arteriovenous Fistula / etiology
  • Arteriovenous Fistula / surgery
  • Atherectomy, Coronary / adverse effects
  • Coronary Disease / therapy*
  • Female
  • Groin
  • Hematoma / etiology
  • Hematoma / surgery
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / etiology
  • Postoperative Complications / surgery
  • Prospective Studies
  • Risk Factors
  • Stents
  • Treatment Outcome