Izvorni znanstveni članak
Access Site Complications Following Cardiac Catheterization Assessed by Duplex Ultrasonography
Ljiljana Banfić
Majda Vrkić Kirhmajer
Marina Vojković
Maja Strozzi
Anton Šmalcelj
Zoran Lasić
Sažetak
Access site complications are major source of morbidity following cardiac catheterization. Their incidence varies in
the literature because of multiple definitions and methods of determining the presence of particular complication. The
aim of this prospective study was to determine the incidence of access site complications following cardiac catheterization
using arterial duplex ultrasonography. A total of 319 consecutive patients, who had cardiac catheterization underwent
femoral artery duplex study 24 to 48 hours following manual hemostasis. Diagnostic angiogram had 232 (71.8%) while
87 (28.2%) had percutaneous coronary intervention (PCI). Femoral artery duplex ultrasound was normal in 247 (77.4%).
Haematoma was found in 48 (15.1%), pseudoaneurysm in 17 (5.3%), AV fistula in 2 (0.6%) and dissection of the femoral
artery in 5 (1.6%) patients. Baseline demografic characteristics were similar in group with normal duplex study and
group with detected complication. Pseudoaneurysm and AV fistula were more commonly observed in patients following
PCI than diagnostic angiogram (9.2% vs. 4.7%, p<0.001). Patients with documented complications more frequently had
concomitant administration of antiplatelet and anticoagulant medication compared to the patients without complications
(p=0.003). Hemodynamic disturbances (hypotension and bradycardia) during manual compression were more frequent
in patients with complication (11% vs. 4.5%, p=0.047). Low threshold for use of duplex ultrasound should be exercised
in patients following cardiac catheterization to establish the presence of access site complications. Special attention
is needed in the setting of aggressive antiplatelet and anticoagulant therapy, interventional procedures and hemodynamic
disturbances during manual hemostas.
Ključne riječi
duplex ultrasonography; access site complications; cardiac catheterization
Hrčak ID:
27206
URI
Datum izdavanja:
7.7.2008.
Posjeta: 1.022 *