Vascular closure devices and the risk of vascular complications after percutaneous coronary intervention in patients receiving glycoprotein IIb-IIIa inhibitors
Vascular closure devices offer advantages over traditional means of obtaining hemostasis after percutaneous coronary intervention (PCI) in terms of patient comfort and time to ambulation. We investigate whether such devices also reduce the risk of vascular complications in selected patient populatio...
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| Veröffentlicht in: | The American journal of cardiology 2001-09, Vol.88 (5), p.493-496 |
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| creator | Resnic, Frederic S Blake, Gavin J Ohno-Machado, Lucila Selwyn, Andrew P Popma, Jeffrey J Rogers, Campbell |
| description | Vascular closure devices offer advantages over traditional means of obtaining hemostasis after percutaneous coronary intervention (PCI) in terms of patient comfort and time to ambulation. We investigate whether such devices also reduce the risk of vascular complications in selected patient populations. We conducted a retrospective analysis of all patients who underwent PCI at our institution between January 1998 and December 1999. Of 3,151 consecutive patients, 3,027 were eligible to receive vascular closure devices. Of these, 1,485 received a closure device and 1,409 received glycoprotein IIb-IIIa antagonists. The overall vascular complication rate, as defined by the need for surgical repair or transfusion, or the development of arteriovenous fistula, pseudoaneurysm, or large hematoma, was 4.20%. By univariate analysis, the use of closure devices was associated with a lower vascular complication rate (3.03% vs 5.52%; p = 0.002) and a shorter length of hospital stay (2.77 vs 3.97 days, p |
| doi_str_mv | 10.1016/S0002-9149(01)01725-8 |
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We investigate whether such devices also reduce the risk of vascular complications in selected patient populations. We conducted a retrospective analysis of all patients who underwent PCI at our institution between January 1998 and December 1999. Of 3,151 consecutive patients, 3,027 were eligible to receive vascular closure devices. Of these, 1,485 received a closure device and 1,409 received glycoprotein IIb-IIIa antagonists. The overall vascular complication rate, as defined by the need for surgical repair or transfusion, or the development of arteriovenous fistula, pseudoaneurysm, or large hematoma, was 4.20%. By univariate analysis, the use of closure devices was associated with a lower vascular complication rate (3.03% vs 5.52%; p = 0.002) and a shorter length of hospital stay (2.77 vs 3.97 days, p <0.001). Multivariate analysis showed a significant reduction in vascular complications with closure devices (odds ratio 0.59, p = 0.007). For the subgroup of patients receiving glycoprotein IIb-IIIa antagonists, the use of closure devices was associated with an even more pronounced reduction in the risk of vascular complications (odds ratio 0.45, p <0.008). Thus, the use of closure devices in selected patients undergoing PCI is associated with a low rate of vascular complications and decreased length of stay. This benefit was most marked for patients receiving glycoprotein IIb-IIIa antagonists.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/S0002-9149(01)01725-8</identifier><identifier>PMID: 11524056</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Age Distribution ; Aged ; Analysis of Variance ; Aneurysm, False - etiology ; Angioplasty, Balloon, Coronary - adverse effects ; Angioplasty, Balloon, Coronary - instrumentation ; Antibodies, Monoclonal - administration & dosage ; Antibodies, Monoclonal, Humanized ; Arteriovenous Fistula - etiology ; Cardiovascular disease ; Chi-Square Distribution ; Coronary Disease - etiology ; Coronary Disease - surgery ; Coronary Vessel Anomalies - etiology ; Coronary Vessels - injuries ; Equipment Safety ; Female ; Heart attacks ; Hematoma - etiology ; Humans ; Incidence ; Maladies cardiovasculaires ; Male ; Middle Aged ; Multivariate Analysis ; Myocardial Infarction - mortality ; Myocardial Infarction - therapy ; Probability ; Radiotherapie. 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We investigate whether such devices also reduce the risk of vascular complications in selected patient populations. We conducted a retrospective analysis of all patients who underwent PCI at our institution between January 1998 and December 1999. Of 3,151 consecutive patients, 3,027 were eligible to receive vascular closure devices. Of these, 1,485 received a closure device and 1,409 received glycoprotein IIb-IIIa antagonists. The overall vascular complication rate, as defined by the need for surgical repair or transfusion, or the development of arteriovenous fistula, pseudoaneurysm, or large hematoma, was 4.20%. By univariate analysis, the use of closure devices was associated with a lower vascular complication rate (3.03% vs 5.52%; p = 0.002) and a shorter length of hospital stay (2.77 vs 3.97 days, p <0.001). Multivariate analysis showed a significant reduction in vascular complications with closure devices (odds ratio 0.59, p = 0.007). For the subgroup of patients receiving glycoprotein IIb-IIIa antagonists, the use of closure devices was associated with an even more pronounced reduction in the risk of vascular complications (odds ratio 0.45, p <0.008). Thus, the use of closure devices in selected patients undergoing PCI is associated with a low rate of vascular complications and decreased length of stay. This benefit was most marked for patients receiving glycoprotein IIb-IIIa antagonists.</description><subject>Age Distribution</subject><subject>Aged</subject><subject>Analysis of Variance</subject><subject>Aneurysm, False - etiology</subject><subject>Angioplasty, Balloon, Coronary - adverse effects</subject><subject>Angioplasty, Balloon, Coronary - instrumentation</subject><subject>Antibodies, Monoclonal - administration & dosage</subject><subject>Antibodies, Monoclonal, Humanized</subject><subject>Arteriovenous Fistula - etiology</subject><subject>Cardiovascular disease</subject><subject>Chi-Square Distribution</subject><subject>Coronary Disease - etiology</subject><subject>Coronary Disease - surgery</subject><subject>Coronary Vessel Anomalies - etiology</subject><subject>Coronary Vessels - injuries</subject><subject>Equipment Safety</subject><subject>Female</subject><subject>Heart attacks</subject><subject>Hematoma - etiology</subject><subject>Humans</subject><subject>Incidence</subject><subject>Maladies cardiovasculaires</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Myocardial Infarction - mortality</subject><subject>Myocardial Infarction - therapy</subject><subject>Probability</subject><subject>Radiotherapie. 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We investigate whether such devices also reduce the risk of vascular complications in selected patient populations. We conducted a retrospective analysis of all patients who underwent PCI at our institution between January 1998 and December 1999. Of 3,151 consecutive patients, 3,027 were eligible to receive vascular closure devices. Of these, 1,485 received a closure device and 1,409 received glycoprotein IIb-IIIa antagonists. The overall vascular complication rate, as defined by the need for surgical repair or transfusion, or the development of arteriovenous fistula, pseudoaneurysm, or large hematoma, was 4.20%. By univariate analysis, the use of closure devices was associated with a lower vascular complication rate (3.03% vs 5.52%; p = 0.002) and a shorter length of hospital stay (2.77 vs 3.97 days, p <0.001). Multivariate analysis showed a significant reduction in vascular complications with closure devices (odds ratio 0.59, p = 0.007). For the subgroup of patients receiving glycoprotein IIb-IIIa antagonists, the use of closure devices was associated with an even more pronounced reduction in the risk of vascular complications (odds ratio 0.45, p <0.008). Thus, the use of closure devices in selected patients undergoing PCI is associated with a low rate of vascular complications and decreased length of stay. This benefit was most marked for patients receiving glycoprotein IIb-IIIa antagonists.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>11524056</pmid><doi>10.1016/S0002-9149(01)01725-8</doi><tpages>4</tpages></addata></record> |
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| subjects | Age Distribution Aged Analysis of Variance Aneurysm, False - etiology Angioplasty, Balloon, Coronary - adverse effects Angioplasty, Balloon, Coronary - instrumentation Antibodies, Monoclonal - administration & dosage Antibodies, Monoclonal, Humanized Arteriovenous Fistula - etiology Cardiovascular disease Chi-Square Distribution Coronary Disease - etiology Coronary Disease - surgery Coronary Vessel Anomalies - etiology Coronary Vessels - injuries Equipment Safety Female Heart attacks Hematoma - etiology Humans Incidence Maladies cardiovasculaires Male Middle Aged Multivariate Analysis Myocardial Infarction - mortality Myocardial Infarction - therapy Probability Radiotherapie. Traitement instrumental. Physiotherapie. Reeducation. Readaptation, orthophonie, crenotherapie. Traitement dietetique et traitements divers (generalites) Retrospective Studies Risk Assessment Risk Factors Sciences biologiques et medicales Sciences medicales Sex Distribution Surgery |
| title | Vascular closure devices and the risk of vascular complications after percutaneous coronary intervention in patients receiving glycoprotein IIb-IIIa inhibitors |
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