Impact of gender on femoral access complications secondary to application of a collagen-based vascular closure device.
BACKGROUND
Vascular complications at the femoral access site continue to be a significant problem after cardiac catheterization procedures. It was the aim of the present study to assess the impact of gender on the incidence of severe femoral access complications following the application of a collagen-based vascular closure device after transfemoral catheterization procedures.


METHODS
A total of 1,294 consecutive patients (977 male, 317 female) underwent closure of femoral access sites with 8F collagen-based vascular closure devices (Angioseal) immediately after diagnostic or interventional coronary catheterization procedures, independently of the coagulation status. All patients were closely monitored for the occurrence of complications during the following 24 hours.


RESULTS
Between male and female patients, there was no difference in the technical performance of the device with successful deployment being achieved in 96.7% and 95.9%, respectively (p=0.60). Severe access complications were found to be significantly higher in female versus male patients (1.6% vs. 0.2%; Odds ratio 7.7, 95% confidence interval 1.5-40.1; p=0.015), although similar accomplishment of an immediate hemostasis was seen in 92.8% and 92.4% of male and female patients (p=0.98).


CONCLUSIONS
Women show a significantly increased risk of developing severe femoral access complications secondary to the application of a collagen-based vascular closure device, although the overall incidence of these complications is relatively low. We speculate that the increased risk in women may be related to smaller arterial dimensions, which could be evaluated by femoral angiography prior to deployment of a closure device.
Eggebrecht
Holger
H
Department of Cardiology, West German Heart Center, University of Duisburg-Essen, Germany. holger.eggebrecht@uni-essen.de
von Birgelen
Clemens
C
Naber
Christoph
C
Kröger
Knut
K
Schmermund
Axel
A
Wieneke
Heinrich
H
Bartel
Thomas
T
Wörtgen
Uta
U
Baumgart
Dietrich
D
Haude
Michael
M
Erbel
Raimund
R
D000328:Adult; D000368:Aged; D006328:Cardiac Catheterization / Q000009:adverse effects* / Q000295:instrumentation* / Q000379:methods; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D024022:Fibrillar Collagens / Q000008:administration & dosage; D015718:Fibrin Tissue Adhesive; D006488:Hemostasis, Surgical / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011677:Punctures / Q000295:instrumentation / Q000379:methods; D012307:Risk Factors; D012737:Sex Factors
D024022:Fibrillar Collagens; D015718:Fibrin Tissue Adhesive