Peripheral vascular complications after conventional and complex percutaneous coronary interventional procedures.
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The results of this study suggest that the overall incidence of access site complications is low but increases with the use of complex cardiovascular interventional procedures.Abstract:
To determine whether complex cardiovascular interventional procedures (including coronary stent implantation, directional atherectomy, aortic valvuloplasty, and the use of an intraaortic balloon pump or cardiopulmonary bypass support) are associated with an increased likelihood of vascular access site complications, 2,400 consecutive cardiac catheterization procedures were prospectively screened over a 12-month study period. Complications occurred in 35 patients after 39 procedures (1.6%) and included the need for vascular surgical repair (17 patients), blood transfusion (28 patients) and systemic antibiotic therapy (7 patients). The incidence of complications after 1,519 diagnostic studies was 0.6%, after 698 conventional coronary balloon angioplasties 2.6%, and after 183 complex interventions 6.0% (p less than 0.0001); 43% of the complications occurred after procedures of greater than 2 hours' duration and 14% occurred in patients in whom arterial sheaths remained in situ for greater than 24 hours. Detailed demographic and procedural characteristics were compared between the 35 patients with vascular complications and 150 patients randomly drawn from a computerized database of the uncomplicated procedures performed during the screening period. By univariate analysis with correction for multiple comparisons, variables predicting the likelihood of vascular complications included: periprocedural use of heparin (p less than 0.001) or fibrinolytic therapy (p less than 0.001), arterial sheath size greater than or equal to 8Fr (p less than 0.001), patient age greater than or equal to 65 years (p = 0.01), and the presence of peripheral vascular disease (p = 0.03). The results of this study suggest that the overall incidence of access site complications is low but increases with the use of complex cardiovascular interventional procedures.(ABSTRACT TRUNCATED AT 250 WORDS)read more
Citations
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ACC/AHA/SCAI 2005 Guideline Update for Percutaneous Coronary Intervention-summary article : A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/SCAI Writing Committee to Update the 2001 Guidelines for Percutaneous Coronary Intervention)
Sidney C. Smith,Ted Feldman,John W. Hirshfeld,Alice K. Jacobs,Morton J. Kern,Spencer B. King,Douglass A. Morrison,William W. O'Neill,Hartzell V. Schaff,Patrick L. Whitlow,David O. Williams,Elliott M. Antman,Cynthia D. Adams,Jeffrey L. Anderson,David P. Faxon,Valentin Fuster,Jonathan L. Halperin,Loren F. Hiratzka,Sharon A. Hunt,Rick A. Nishimura,Joseph P. Ornato,Richard L. Page,Barbara Riegel +22 more
TL;DR: The American College of Cardiology/American Heart Association/Society for Cardiovascular Angiography and Interventions (ACC/AHA/SCAI) 2005 Guideline Update for Percutaneous Coronary Intervention (PCI) contains changes in the recommendations, along with supporting text.
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Perioperative blood transfusion and blood conservation in cardiac surgery: the Society of Thoracic Surgeons and The Society of Cardiovascular Anesthesiologists clinical practice guideline.
Victor A. Ferraris,Suellen P. Ferraris,Sibu P. Saha,Eugene A. Hessel,Constance K. Haan,B. David Royston,Charles R. Bridges,Robert S.D. Higgins,George J. Despotis,Jeremiah R. Brown,Bruce D. Spiess,Linda Shore-Lesserson,Mark Stafford-Smith,C. David Mazer,Elliott Bennett-Guerrero,Steven E. Hill,Simon C. Body +16 more
TL;DR: Based on available evidence, institution-specific protocols should screen for high- risk patients, as blood conservation interventions are likely to be most productive for this high-risk subset of patients.
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ACC/AHA Guidelines for Percutaneous Coronary Intervention (Revision of the 1993 PTCA Guidelines)—Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1993 Guidelines for Percutaneous Transluminal Coronary Angioplasty) Endorsed by the Society for Cardiac Angiography and Interventions
Sidney C. Smith,James T. Dove,Alice K. Jacobs,J. Ward Kennedy,Dean J. Kereiakes,Morton J. Kern,Richard E. Kuntz,Jeffery J. Popma,Hartzell V. Schaff,David O. Williams,Raymond J. Gibbons,Joseph P. Alpert,Kim A. Eagle,David P. Faxon,Valentin Fuster,Timothy J. Gardner,Gabriel Gregoratos,Richard O. Russell +17 more
TL;DR: The American College of Cardiology/American Heart Association (ACC/AHA) Task Force on Practice Guidelines was formed to gather information and make recommendations about appropriate use of technology for the diagnosis and treatment of patients with cardiovascular disease as discussed by the authors.
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Effect of transradial access on quality of life and cost of cardiac catheterization: A randomized comparison.
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