Incidence and outcome of femoral vascular complications among 18,165 patients undergoing cardiac catheterisation

Abstract Background Arteriovenous fistulas (AVF) and arterial pseudoaneurysms (PSA) are potentially harmful complications of diagnostic and interventional cardiac catheterisation. Incidence, risk factors and clinical outcome are not well defined yet, although important for stratification and treatme...

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Veröffentlicht in:International journal of cardiology 2009-06, Vol.135 (1), p.66-71
Hauptverfasser: Ohlow, Marc-Alexander, Secknus, Maria-Anna, von Korn, Hubertus, Neumeister, Axel, Wagner, Andreas, Yu, Jiangtao, Lauer, Bernward
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container_end_page 71
container_issue 1
container_start_page 66
container_title International journal of cardiology
container_volume 135
creator Ohlow, Marc-Alexander
Secknus, Maria-Anna
von Korn, Hubertus
Neumeister, Axel
Wagner, Andreas
Yu, Jiangtao
Lauer, Bernward
description Abstract Background Arteriovenous fistulas (AVF) and arterial pseudoaneurysms (PSA) are potentially harmful complications of diagnostic and interventional cardiac catheterisation. Incidence, risk factors and clinical outcome are not well defined yet, although important for stratification and treatment. Methods A total of 18,165 consecutive patients undergoing cardiac catheterisation were enrolled in our prospective registry. For the diagnosis of AVF and PSA a clinical examination was performed in every patient followed by a Duplex examination in case of clinical suspicion of AVF/PSA. The impact of the following risk factors was assessed: age, body mass index, puncture of left vs. right groin, gender, hypertension, sheath size, peripheral artery disease, coumadin therapy, glycoprotein IIb/IIIa-inhibitors, pre-treatment with thrombolytics, and emergency procedures. Results Within 3 years a total of 334 complications were found (1.8%). The incidence of AVF and PSA was 0.6% ( n = 107) and 1.2% ( n = 227), respectively. The following significant independent risk factors were identified: arterial hypertension (odds ratio [OR]) = 1.86, female gender (OR = 1.65), and emergency procedures (OR = 2.13). During follow-up (mean 48 ± 10 months) only 11% of all AVF underwent operative repair due to symptoms. All PSA could be treated successfully either by manual compression, thrombin injection, or surgery. The overall mortality was 0.8%. Conclusion Almost 2% of patients undergoing cardiac catheterisation acquire femoral AVF or PSA, for which patient- or procedure-related risk factors could be identified. Most of AVF and PSA could be managed conservatively or without any treatment, the overall mortality is low.
doi_str_mv 10.1016/j.ijcard.2008.03.035
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Incidence, risk factors and clinical outcome are not well defined yet, although important for stratification and treatment. Methods A total of 18,165 consecutive patients undergoing cardiac catheterisation were enrolled in our prospective registry. For the diagnosis of AVF and PSA a clinical examination was performed in every patient followed by a Duplex examination in case of clinical suspicion of AVF/PSA. The impact of the following risk factors was assessed: age, body mass index, puncture of left vs. right groin, gender, hypertension, sheath size, peripheral artery disease, coumadin therapy, glycoprotein IIb/IIIa-inhibitors, pre-treatment with thrombolytics, and emergency procedures. Results Within 3 years a total of 334 complications were found (1.8%). The incidence of AVF and PSA was 0.6% ( n = 107) and 1.2% ( n = 227), respectively. The following significant independent risk factors were identified: arterial hypertension (odds ratio [OR]) = 1.86, female gender (OR = 1.65), and emergency procedures (OR = 2.13). During follow-up (mean 48 ± 10 months) only 11% of all AVF underwent operative repair due to symptoms. All PSA could be treated successfully either by manual compression, thrombin injection, or surgery. The overall mortality was 0.8%. Conclusion Almost 2% of patients undergoing cardiac catheterisation acquire femoral AVF or PSA, for which patient- or procedure-related risk factors could be identified. Most of AVF and PSA could be managed conservatively or without any treatment, the overall mortality is low.</description><identifier>ISSN: 0167-5273</identifier><identifier>EISSN: 1874-1754</identifier><identifier>DOI: 10.1016/j.ijcard.2008.03.035</identifier><identifier>PMID: 18617281</identifier><identifier>CODEN: IJCDD5</identifier><language>eng</language><publisher>Shannon: Elsevier Ireland Ltd</publisher><subject>Aged ; Aneurysm, False - epidemiology ; Aneurysm, False - etiology ; Arteriovenous fistula ; Arteriovenous Fistula - epidemiology ; Arteriovenous Fistula - etiology ; Biological and medical sciences ; Blood and lymphatic vessels ; Cardiac catheterisation ; Cardiac Catheterization - adverse effects ; Cardiac Catheterization - statistics &amp; numerical data ; Cardiology. Vascular system ; Cardiovascular ; Coronary Vessels - injuries ; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous ; Emergency Medical Services - statistics &amp; numerical data ; Female ; Follow-Up Studies ; Humans ; Hypertension - epidemiology ; Incidence ; Male ; Medical sciences ; Middle Aged ; Pseudoaneurysm ; Registries - statistics &amp; numerical data ; Risk Factors ; Treatment Outcome ; Vascular injury</subject><ispartof>International journal of cardiology, 2009-06, Vol.135 (1), p.66-71</ispartof><rights>Elsevier Ireland Ltd</rights><rights>2008 Elsevier Ireland Ltd</rights><rights>2009 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c511t-a12dcf39079e950c450e2b2010a647a75185c9a5152f37e9584a16e811f745463</citedby><cites>FETCH-LOGICAL-c511t-a12dcf39079e950c450e2b2010a647a75185c9a5152f37e9584a16e811f745463</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ijcard.2008.03.035$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=21684465$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18617281$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ohlow, Marc-Alexander</creatorcontrib><creatorcontrib>Secknus, Maria-Anna</creatorcontrib><creatorcontrib>von Korn, Hubertus</creatorcontrib><creatorcontrib>Neumeister, Axel</creatorcontrib><creatorcontrib>Wagner, Andreas</creatorcontrib><creatorcontrib>Yu, Jiangtao</creatorcontrib><creatorcontrib>Lauer, Bernward</creatorcontrib><title>Incidence and outcome of femoral vascular complications among 18,165 patients undergoing cardiac catheterisation</title><title>International journal of cardiology</title><addtitle>Int J Cardiol</addtitle><description>Abstract Background Arteriovenous fistulas (AVF) and arterial pseudoaneurysms (PSA) are potentially harmful complications of diagnostic and interventional cardiac catheterisation. Incidence, risk factors and clinical outcome are not well defined yet, although important for stratification and treatment. Methods A total of 18,165 consecutive patients undergoing cardiac catheterisation were enrolled in our prospective registry. For the diagnosis of AVF and PSA a clinical examination was performed in every patient followed by a Duplex examination in case of clinical suspicion of AVF/PSA. The impact of the following risk factors was assessed: age, body mass index, puncture of left vs. right groin, gender, hypertension, sheath size, peripheral artery disease, coumadin therapy, glycoprotein IIb/IIIa-inhibitors, pre-treatment with thrombolytics, and emergency procedures. Results Within 3 years a total of 334 complications were found (1.8%). The incidence of AVF and PSA was 0.6% ( n = 107) and 1.2% ( n = 227), respectively. The following significant independent risk factors were identified: arterial hypertension (odds ratio [OR]) = 1.86, female gender (OR = 1.65), and emergency procedures (OR = 2.13). During follow-up (mean 48 ± 10 months) only 11% of all AVF underwent operative repair due to symptoms. All PSA could be treated successfully either by manual compression, thrombin injection, or surgery. The overall mortality was 0.8%. Conclusion Almost 2% of patients undergoing cardiac catheterisation acquire femoral AVF or PSA, for which patient- or procedure-related risk factors could be identified. Most of AVF and PSA could be managed conservatively or without any treatment, the overall mortality is low.</description><subject>Aged</subject><subject>Aneurysm, False - epidemiology</subject><subject>Aneurysm, False - etiology</subject><subject>Arteriovenous fistula</subject><subject>Arteriovenous Fistula - epidemiology</subject><subject>Arteriovenous Fistula - etiology</subject><subject>Biological and medical sciences</subject><subject>Blood and lymphatic vessels</subject><subject>Cardiac catheterisation</subject><subject>Cardiac Catheterization - adverse effects</subject><subject>Cardiac Catheterization - statistics &amp; numerical data</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular</subject><subject>Coronary Vessels - injuries</subject><subject>Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous</subject><subject>Emergency Medical Services - statistics &amp; numerical data</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Hypertension - epidemiology</subject><subject>Incidence</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Pseudoaneurysm</subject><subject>Registries - statistics &amp; numerical data</subject><subject>Risk Factors</subject><subject>Treatment Outcome</subject><subject>Vascular injury</subject><issn>0167-5273</issn><issn>1874-1754</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFks-L1TAQgIMo7tvV_0AkFz1tnzNp0qQXQRZ_LCx4UM8hm07X1LZ5Ju3C_vemvoeCFyEwkPlmGL4Zxl4g7BGweTPsw-Bd6vYCwOyhLk89Yjs0WlaolXzMdgXTlRK6PmPnOQ8AINvWPGVnaBrUwuCOHa5nHzqaPXE3dzyui48T8djznqaY3MjvXfbr6BIvicMYvFtCnDN3U5zvOJpLbBQ_lE-al8zXuaN0F0NJbbMF50tcvtNCKeTflc_Yk96NmZ6f4gX79uH916tP1c3nj9dX724qrxCXyqHofF-3oFtqFXipgMStAATXSO20QqN86xQq0de6IEY6bMgg9loq2dQX7PWx7yHFnyvlxU4hexpHN1Ncs210DW2xUUB5BH2KOSfq7SGFyaUHi2A303awR9N2M22hLk-Vspen_uvtRN3fopPaArw6AUWgG_vkiun8hxPYGCmbrdHbI0fFxn2gZLMP20K6kMgvtovhf5P828CPYS6LGn_QA-Uhrmkupi3aLCzYL9tVbEcBBkCBgPoX3eiykg</recordid><startdate>20090612</startdate><enddate>20090612</enddate><creator>Ohlow, Marc-Alexander</creator><creator>Secknus, Maria-Anna</creator><creator>von Korn, Hubertus</creator><creator>Neumeister, Axel</creator><creator>Wagner, Andreas</creator><creator>Yu, Jiangtao</creator><creator>Lauer, Bernward</creator><general>Elsevier Ireland Ltd</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20090612</creationdate><title>Incidence and outcome of femoral vascular complications among 18,165 patients undergoing cardiac catheterisation</title><author>Ohlow, Marc-Alexander ; Secknus, Maria-Anna ; von Korn, Hubertus ; Neumeister, Axel ; Wagner, Andreas ; Yu, Jiangtao ; Lauer, Bernward</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c511t-a12dcf39079e950c450e2b2010a647a75185c9a5152f37e9584a16e811f745463</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Aged</topic><topic>Aneurysm, False - epidemiology</topic><topic>Aneurysm, False - etiology</topic><topic>Arteriovenous fistula</topic><topic>Arteriovenous Fistula - epidemiology</topic><topic>Arteriovenous Fistula - etiology</topic><topic>Biological and medical sciences</topic><topic>Blood and lymphatic vessels</topic><topic>Cardiac catheterisation</topic><topic>Cardiac Catheterization - adverse effects</topic><topic>Cardiac Catheterization - statistics &amp; numerical data</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular</topic><topic>Coronary Vessels - injuries</topic><topic>Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous</topic><topic>Emergency Medical Services - statistics &amp; numerical data</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Hypertension - epidemiology</topic><topic>Incidence</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Pseudoaneurysm</topic><topic>Registries - statistics &amp; numerical data</topic><topic>Risk Factors</topic><topic>Treatment Outcome</topic><topic>Vascular injury</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ohlow, Marc-Alexander</creatorcontrib><creatorcontrib>Secknus, Maria-Anna</creatorcontrib><creatorcontrib>von Korn, Hubertus</creatorcontrib><creatorcontrib>Neumeister, Axel</creatorcontrib><creatorcontrib>Wagner, Andreas</creatorcontrib><creatorcontrib>Yu, Jiangtao</creatorcontrib><creatorcontrib>Lauer, Bernward</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ohlow, Marc-Alexander</au><au>Secknus, Maria-Anna</au><au>von Korn, Hubertus</au><au>Neumeister, Axel</au><au>Wagner, Andreas</au><au>Yu, Jiangtao</au><au>Lauer, Bernward</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Incidence and outcome of femoral vascular complications among 18,165 patients undergoing cardiac catheterisation</atitle><jtitle>International journal of cardiology</jtitle><addtitle>Int J Cardiol</addtitle><date>2009-06-12</date><risdate>2009</risdate><volume>135</volume><issue>1</issue><spage>66</spage><epage>71</epage><pages>66-71</pages><issn>0167-5273</issn><eissn>1874-1754</eissn><coden>IJCDD5</coden><abstract>Abstract Background Arteriovenous fistulas (AVF) and arterial pseudoaneurysms (PSA) are potentially harmful complications of diagnostic and interventional cardiac catheterisation. Incidence, risk factors and clinical outcome are not well defined yet, although important for stratification and treatment. Methods A total of 18,165 consecutive patients undergoing cardiac catheterisation were enrolled in our prospective registry. For the diagnosis of AVF and PSA a clinical examination was performed in every patient followed by a Duplex examination in case of clinical suspicion of AVF/PSA. The impact of the following risk factors was assessed: age, body mass index, puncture of left vs. right groin, gender, hypertension, sheath size, peripheral artery disease, coumadin therapy, glycoprotein IIb/IIIa-inhibitors, pre-treatment with thrombolytics, and emergency procedures. Results Within 3 years a total of 334 complications were found (1.8%). The incidence of AVF and PSA was 0.6% ( n = 107) and 1.2% ( n = 227), respectively. The following significant independent risk factors were identified: arterial hypertension (odds ratio [OR]) = 1.86, female gender (OR = 1.65), and emergency procedures (OR = 2.13). During follow-up (mean 48 ± 10 months) only 11% of all AVF underwent operative repair due to symptoms. All PSA could be treated successfully either by manual compression, thrombin injection, or surgery. The overall mortality was 0.8%. Conclusion Almost 2% of patients undergoing cardiac catheterisation acquire femoral AVF or PSA, for which patient- or procedure-related risk factors could be identified. Most of AVF and PSA could be managed conservatively or without any treatment, the overall mortality is low.</abstract><cop>Shannon</cop><pub>Elsevier Ireland Ltd</pub><pmid>18617281</pmid><doi>10.1016/j.ijcard.2008.03.035</doi><tpages>6</tpages></addata></record>
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subjects Aged
Aneurysm, False - epidemiology
Aneurysm, False - etiology
Arteriovenous fistula
Arteriovenous Fistula - epidemiology
Arteriovenous Fistula - etiology
Biological and medical sciences
Blood and lymphatic vessels
Cardiac catheterisation
Cardiac Catheterization - adverse effects
Cardiac Catheterization - statistics & numerical data
Cardiology. Vascular system
Cardiovascular
Coronary Vessels - injuries
Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous
Emergency Medical Services - statistics & numerical data
Female
Follow-Up Studies
Humans
Hypertension - epidemiology
Incidence
Male
Medical sciences
Middle Aged
Pseudoaneurysm
Registries - statistics & numerical data
Risk Factors
Treatment Outcome
Vascular injury
title Incidence and outcome of femoral vascular complications among 18,165 patients undergoing cardiac catheterisation
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