Access Site Complications by Intracardiac Interventions

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Abstract

In recent decades, the number of intracardiac procedures using percutaneous puncture access has increased manifold. Despite the acquisition by operators of expertise and standardization of methods, the problem of complications remains relevant.

AIM: to analyze the frequency and nature of complications of percutaneous access in intracardiac interventions. Suggest recommendations to reduce the incidence of complications.

MATERIALS AND METHODS: analysis of data published in international peer-reviewed journals on the topic, as well as the experience of the vascular surgery clinic of St. Katarina's Hospital.

CONCLUSIONS: the frequency and severity of complications depend on the experience of the operator, the size and frequency of changing the instrument, as well as compliance with the rules of preoperative diagnosis and postoperative management of the patient.

RECOMMENDATIONS: standardized preoperative preparation, careful planning of the intervention, analysis of the state of the access vessels, compliance with the rules of vessel puncture and competent performance of postoperative compression in combination with the use of suturing devices according to indications can reduce the frequency and severity of complications.

About the authors

Alexander V. Kimkov

St.-Katharinen Hospital GmbH Frechen

Author for correspondence.
Email: alexandre04@inbox.ru
ORCID iD: 0000-0002-1774-938X

doctor of medical sciences

Germany, Germany

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Supplementary files

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2. Fig. 1. Topography of the femoral artery (from [36])

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3. Fig. 2. Massive hematoma in the right inguinal region and thigh after percutaneous coronary intervention (author’s case)

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4. Fig. 3. Massive puncture site hematoma extending to the proximal femur; a ― radiological image; b ― rapid soft tissue necrosis due to hematoma pressure from the inside; c ― clinical presentation 8 days after hematoma evacuation and revision of the puncture site (author’s case)

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5. Fig. 4. Giant lymphocele (> 2.5 L) after evacuation of a retroperitoneal hematoma (author’s case)

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6. Fig. 5. Post-intervention arteriovenous fistula. The arrow indicates contrasting of the femoral vein (author’s case)

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Copyright (c) 2022 Kimkov A.V.

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