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Strategies to Minimize Access Site-related Complications in Patients Undergoing Transfemoral Artery Procedures with Large-bore Devices.
- Source :
-
Current vascular pharmacology [Curr Vasc Pharmacol] 2024; Vol. 22 (2), pp. 79-87. - Publication Year :
- 2024
-
Abstract
- Large bore accesses refer to accesses with a diameter of 10 French or greater and are necessary for various medical devices, including those used in transcatheter aortic valve replacement, endovascular aneurysm repair stent-grafts, and percutaneous mechanical support devices. Notably, the utilization of these devices via femoral access is steadily increasing due to advancements in technology and implantation techniques, which are expanding the pool of patients suitable for percutaneous procedures. However, procedures involving large bore devices carry a high risk of bleeding and vascular complications (VCs), impacting both morbidity and long-term mortality. In this review article, we will first discuss the incidence, determinants, and prognostic impact of VCs in patients undergoing large bore access procedures. Subsequently, we will explore the strategies developed in recent years to minimize VCs, including techniques for optimizing vascular puncture through femoral cannulation, such as the use of echo-guided access cannulation and fluoroscopic guidance. Additionally, we will evaluate existing vascular closure devices designed for large bore devices. Finally, we will consider new pharmacological strategies aimed at reducing the risk of periprocedural access-related bleeding.<br /> (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)
- Subjects :
- Humans
Risk Factors
Vascular Closure Devices
Endovascular Procedures adverse effects
Endovascular Procedures instrumentation
Treatment Outcome
Hemostatic Techniques instrumentation
Hemostatic Techniques adverse effects
Vascular Access Devices adverse effects
Equipment Design
Risk Assessment
Femoral Artery
Hemorrhage prevention & control
Hemorrhage etiology
Catheterization, Peripheral adverse effects
Catheterization, Peripheral instrumentation
Punctures
Subjects
Details
- Language :
- English
- ISSN :
- 1875-6212
- Volume :
- 22
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Current vascular pharmacology
- Publication Type :
- Academic Journal
- Accession number :
- 38073100
- Full Text :
- https://doi.org/10.2174/0115701611233184231206100222