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Preoperative Risk Factors for Access Site Failure in Ultrasound-Guided Percutaneous Treatment of TASC C and D Aorto-Iliac Occlusive Disease
- Source :
- Annals of vascular surgery. 79
- Publication Year :
- 2021
-
Abstract
- Objective At our institution, we adopted routinely ultrasound guided approach for all percutaneous procedures. The objective of this study was to describe the predictors of access site failures (ASFs) in patients undergoing percutaneous aorto iliac revascularization and to also evaluate whether other factors such as time period or different vascular devices may influence outcomes in terms of ASFs. Methods We reviewed all consecutive percutaneous revascularizations performed for aortoiliac occlusion or stenosis at our institution from 2011 to 2020. All procedure were performed using an ultrasound (US) guided common femoral access. The primary outcome was ASFs, defined as bleeding or groin hematomas that required transfusions; pseduoaneurysm (diagnosed by US); retroperitoneal hematoma; artery laceration or ruptured (diagnosed intraoperatively); and thrombosis. Multivariable logistic regression was used to determine predictors of ASFs. Results A total of 502 femoral arteries were accessed under DUS guidance with no failure in sheath placement. Technical success was achieved in 498 of 502 procedures (99.2%). ASFs occurred in 21 patients (7%); but year of procedure appear to be associated with an excess of ASFs as rates were different between the first and second period of the study (10.9% vs 4.8%, P = .04). Results of multivariable logistic regression model indicated that independent predictors of ASFs were common femoral artery (CFA) calcification peripheral artery calcium scoring system (PACCS) grade (odds ratio [OR], 8.7; 95% confidence interval [CI], 5.5-13.7), and CFA diameter (OR, 0.46; 95% CI, 0.25-0.85). Compared to patients with successful percutaneous access, ASFs resulted in longer post-op lengths of stay (P = Conclusion Percutaneous US guided access can be safely performed in patients undergoing endovascular procedures for aorto iliac revascularization with TASC C and D lesions. CFA calcification PACCS grade greater than 3 and smaller femoral vessel diameter are independent risk factors for ASFs.
- Subjects :
- Male
medicine.medical_specialty
Percutaneous
Time Factors
medicine.medical_treatment
Aortic Diseases
Femoral artery
Punctures
Revascularization
Ultrasound guidance
Iliac Artery
Risk Assessment
Peripheral Arterial Disease
Risk Factors
medicine.artery
percutaneous access
Occlusion
Catheterization, Peripheral
Medicine
Humans
Treatment Failure
Ultrasonography, Interventional
Aged
Retrospective Studies
common femoral artery
business.industry
Femoral vessel
Endovascular Procedures
General Medicine
Odds ratio
Middle Aged
medicine.disease
Thrombosis
Surgery
Femoral Artery
Stenosis
medicine.anatomical_structure
Female
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 16155947
- Volume :
- 79
- Database :
- OpenAIRE
- Journal :
- Annals of vascular surgery
- Accession number :
- edsair.doi.dedup.....7c15b27e8bf0c3f0defb108644253395