An evaluation of peripheral vascular access site complications following coronary angiography and percutaneous coronary intervention (PCI)

Abstract

Background: Peripheral vascular access site complications are known to occur following coronary angiography and percutaneous coronary intervention (PCI). The aim of this thesis was to determine the incidence and predictors for peripheral vascular access site complications following coronary angiography and PCI. Method: A retrospective evaluation was conducted on routinely collected data in an Australian public hospital following coronary angiography and PCI between 2007 and 2012. Backwards conditional logistic regression techniques were used to identify determinants of complications observed. Results: 3793 patient procedures were analysed. Most patients were male (n= 2408; 63.5%) with a mean age of 65.9 years (SD 12.2). Complications were experienced by 46.5% (n= 1764); including haematoma (n= 586), bleeding (n=362) and bruising (n= 1690; 44.6%). Risk factors for haematoma were female gender with OR (95% CI) 1.41, (1.05-1.88), more than 1 arterial puncture (OR 2.19, 1.50-3.20) and pre sheath removal SBP of ≥ 140mmHg (OR 1.63, 1.22-2.17). Radial access (OR 0.24, 0.11-0.50) and diabetes (OR 0.65, 0.45-0.95) was associated with fewer haematomas. Risk factors for bleeding included PCI procedure (OR 3.54, 2.02-6.20) and history of hypertension (OR 1.81, 1.15-2.86). Lower risk factors for bleeding were radial access (OR 0.10, 0.03-0.43) and later procedural year (OR 0.37, 0.18-0.78). Risk factors for bruising were female gender OR 1.38 (1.16-1.63), PCI procedure (OR 2.24, 1.38-3.65), more than 1 arterial puncture (OR 1.76, 1.37-2.26) and SBP of ≥ 140mmHg (OR 1.46, 1.24-1.73); with radial access (OR 0.46, 0.34-0.61) and diabetes (OR 0.60, 0.49-0.74) associated with less bruising. Conclusion: The results provides insight into the frequency and risk factors for complications, and although serious complications were observed to be rare, less serious complications appear relatively common but are likely to be of great significance for patients

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