Risk Management of Femoral Arterial Access-Related Complications in Percutaneous Coronary Intervention
Femoral vascular access related complications are associated with increased morbidity, mortality, length of stay and cost. Bleeding from a femoral arterial puncture site is the most common complication seen; however, there is heterogeneity in the definition of bleeding used in Acute Coronary Syndrome (ACS) trials. The most commonly used, the Thrombolysis in Myocardial Infarction (TIMI) criteria, divide bleeding into major (>5 g/dL decrease in the haemoglobin concentration or a ≥15 % absolute decrease in haematocrit), minor (≥3 g/dL decrease in the haemoglobin concentration or ≥10 % decrease in the haemotocrit if bleeding is observed, ≥4g/dL and ≥12 % if bleeding not seen), and minimal (any clinically overt sign of haemorrhage associated with a <3g/dL decrease in the haemoglobin concentration or <9 % decrease in the haematocrit) . Similarly, there exists great variability (5–20 %) in the incidence of reported femoral vascular access complications. A preventative approach is described here.
KeywordsBleeding Femoral Puncture Haemorrhage Pseudoaneurysm
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