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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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 & 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</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>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21684465$$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 & 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 & 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 & 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 & 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 & 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 & 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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