Closure device use for common femoral artery antegrade access is higher risk than retrograde access
| Autor: | Jose Lopez, Caitlin W. Hicks, James C. Iannuzzi, Joel L. Ramirez, Michael S. Conte, Devin S. Zarkowsky, Peter Schneider, Eric J. Smith |
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| Rok vydání: | 2021 |
| Předmět: |
Male
Time Factors Databases Factual 6.3 Medical devices Femoral artery 030204 cardiovascular system & hematology Cardiovascular Logistic regression Peripheral 030218 nuclear medicine & medical imaging 0302 clinical medicine Risk Factors Antegrade arterial access Occlusion 80 and over Medicine Aged 80 and over Access site complications Hematoma General Medicine Middle Aged Femoral Artery Treatment Outcome Access site hematomas Female Cardiology and Cardiovascular Medicine Vascular Closure Devices medicine.medical_specialty Clinical Sciences Lower extremity peripheral arterial interventions Hemorrhage Punctures Risk Assessment Article Retrograde arterial access Catheterization Databases 03 medical and health sciences Clinical Research medicine.artery Catheterization Peripheral Humans Factual Retrospective Studies Aged Endovascular surgery Hemostatic Techniques business.industry Evaluation of treatments and therapeutic interventions Device use medicine.disease Surgery Arterial closure device Stenosis Good Health and Well Being Cardiovascular System & Hematology Access site business |
| Zdroj: | Ann Vasc Surg |
| ISSN: | 0890-5096 |
| DOI: | 10.1016/j.avsg.2021.03.009 |
| Popis: | OBJECTIVE: Although the use of closure devices (CD) for femoral artery antegrade access (AA) is not in the instructions for use (IFU) for many devices, AA has been reported to be associated with a lower incidence of access site complications compared to manual compression alone. We hypothesized that CD use for AA would not be associated with a clinically significant increased odds of access site complications compared to CD use for retrograde access (RA). METHODS: This was a retrospective review of the Vascular Quality Initiative from 2010 to 2019 for infrainguinal peripheral vascular interventions with common femoral artery access closed with a CD. Patients who had a cutdown or multiple access sites were excluded. Cases were then stratified into whether access was antegrade or retrograde. Hierarchical multivariable logistic regressions controlling for hospital level variation were used to examine the independent association between AA and access site complications. The primary outcomes were access site hematoma, stenosis, or occlusion as defined in the VQI. The secondary outcome was the development of an access site hematoma requiring an intervention, which was defined as transfusion, thrombin injection, or surgery. Sensitivity analyses after coarsened exact matching were performed to reduce residual bias. RESULTS: Overall, 72,463 cases were identified and 6,070 (8.4%) had AA. Patients with AA were less likely to be smokers (27.2% vs 33.0%) or obese (31.5% vs 35.6%; all P |
| Databáze: | OpenAIRE |
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