Incidence and Risk Factors of Complications following Antegrade Common Femoral Artery Access

Abstract

Background: Bleeding and vascular complications following retrograde common femoral artery access are studied. Access site complications, their incidence, and risk factors following antegrade access remain unclear. Materials and Methods: We retrospectively analyzed 189 patients from our prospectively collected database at Jain Institute of Vascular Sciences, Bengaluru, India. All patients had antegrade femoral access and underwent femoral and popliteal artery interventions from January 2013 to December 2014. We aimed to study incidence, risk factors, length of postintervention hospital stay, and early morbidity following antegrade femoral access. Antegrade direct arterial punctures resulted in a complication rate of 14.28%, which comprised 20 ecchymosis (74.07%), 5 groin hematoma (18.51%), and 2 pseudoaneurysm (0.07%). Two patients required blood transfusion. Groin hematoma was common in females (3 vs. 2 patients) than males but had less ecchymosis (7 vs. 13 patients). Age more than 69 years, female sex, 7 Fr sheath size, direct arterial puncture by palpation, and manual compression were associated with higher incidence of complications. Complicated patients had longer hospital stay (3.52 ± 1.19 days vs 1.34 ± 0.59; range 1–7 days; P = 0.0001). Conclusion: Several factors predict access site-related complications following antegrade femoral access, notably gender, age, ultrasound guidance, sheath size, and closure device. Knowledge of these findings could be useful to determine strategies to reduce access site vascular and bleeding risk and improve outcomes.

Keywords

• Access site complications
• antegrade access
• femoral access