title: Major femoral vascular access complications after coronary diagnostic and interventional procedures: A Danish register study.
abstract: BACKGROUND
  Vascular access complications after coronary angiography (CAG) and percutaneous coronary intervention (PCI) are known to increase morbidity, prolong hospitalization and raise hospital costs. Therefore, risk factor identification and improvement of safety strategies for vascular management are important. We aimed to assess the incidence of major vascular complications related to femoral access, and to identify potential risk factors.
  
  
  METHODS
  Over a period of six years, 23,870 index procedures (CAG) were performed in two centres, prospectively entered in the database and retrospectively analysed. Data was obtained from the Eastern Danish Heart Registry and cross-matched with data from the Danish Vascular Registry. Index procedures were defined as the first trans-femoral procedure. Demographic, procedural and mortality data, as well as information on access complications requiring surgery within 30 days were collected. Mortality data were collected for minimum 12 months.
  
  
  RESULTS
  We identified 130 (0.54%) access complications requiring surgery; 65 pseudoaneurysms (0.28%), 46 arterial occlusions (0.19%), 15 hematomas (nine groin and six retroperitoneal hematomas) (0.06%), and 4 arterial dissections (0.02%). Risk factors for complications were left sided femoral access (OR 4.11 [2.29-7.37] p<0.001), peripheral arterial disease (PAD) (OR 2.42 [1.48-3.94] p<0.0001) and female sex (OR 2.22 [1.51-3.24] p<0.0001).
  
  
  CONCLUSIONS
  Vascular complications related to femoral access in coronary diagnostic and interventional procedures are low (0.54%). Risk factors were left sided access, PAD, and female sex.
authors.affiliation: Department of Radiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark. Electronic address: dittedencker@gmail.com.
authors.forename: Ditte
authors.initials: D
authors.lastname: Dencker
authors.affiliation: Department of Cardiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
authors.forename: Frants
authors.initials: F
authors.lastname: Pedersen
authors.affiliation: Department of Cardiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
authors.forename: Thomas
authors.initials: T
authors.lastname: Engstrøm
authors.affiliation: Department of Cardiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
authors.forename: Lars
authors.initials: L
authors.lastname: Køber
authors.affiliation: Department of Cardiology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark.
authors.forename: Søren
authors.initials: S
authors.lastname: Højberg
authors.affiliation: Department of Radiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
authors.forename: Michael B
authors.initials: MB
authors.lastname: Nielsen
authors.affiliation: Copenhagen Academy for Medical Education and Simulation, Capital Region, Copenhagen, Denmark.
authors.forename: Torben V
authors.initials: TV
authors.lastname: Schroeder
authors.affiliation: Department of Radiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; Department of Vascular Surgery, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
authors.forename: Lars
authors.initials: L
authors.lastname: Lönn
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017541:Aneurysm, False / Q000453:epidemiology / Q000209:etiology; D001157:Arterial Occlusive Diseases / Q000453:epidemiology / Q000209:etiology; D017023:Coronary Angiography / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data*; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D006406:Hematoma / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data*; D016491:Peripheral Vascular Diseases / Q000453:epidemiology / Q000209:etiology; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D062666:Vascular Access Devices / Q000009:adverse effects / Q000706:statistics & numerical data*
keywords: Complication; Coronary angiography; Femoral access; Percutaneous coronary intervention