Percutaneous artErial closure devices and ultrasound‐guided Trans‐femoRal puncture ObservatioNal InvestigatiOn: Insights from the PETRONIO registry. Issue 3 (17th June 2021)

• Record Type: Journal Article
• Authors: Iannopollo, Gianmarco; Nobile, Giampiero; Lanzilotti, Valerio; Capecchi, Alessandro; Verardi, Roberto; Bruno, Matteo; Somaschini, Alberto; Rubboli, Andrea; Di Pasquale, Giuseppe; Casella, Gianni
• Is Part Of: Catheterization and cardiovascular interventions. Volume 99:Issue 3(2022)
• Page Start: 795
• Page End: 803
• Publication Date: 2021-06-17
• Subjects: access site bleeding -- femoral artery -- ultrasound guided puncture -- vascular closure device; Heart -- Diseases -- Diagnosis -- Periodicals; Cardiac catheterization -- Periodicals; 616.1207572
• DOI: 10.1002/ccd.29828
• Languages: English
• ISSNs: 1522-1946

Abstract

Abstract: Objective: To evaluate the safety of a single and combined use of ultrasound‐guided femoral puncture (U) and percutaneous arterial closure devices (P) in femoral artery procedures (FAP) compared to fluoroscopic guidance (F) and manual compression (M) in a large radial‐focused interventional centre. Background: U and P, taken individually, have improved safety in femoral arterial access procedures compared to traditional techniques. Methods: All FAP performed between July 2017 and December 2018 in our centre were divided into three phases: (a) control period with F and M mainly performed; (b) phase out period where U and P were introduced; (c) intervention period where a 6‐month expertise on the novel techniques was acquired. The overall population was further stratified into subgroups: F/M, U/M, F/P, U/P. The primary study endpoint was in‐hospital access site bleeding events (BE) according to the BARC criteria. The secondary endpoint was vascular site complications (VASC). Results: Four hundred eighteen procedures (14%) out of 3025 were performed via FA access during the study period. The overall access‐site in‐hospital BE were 97 (23%). Decreasing rates of BE (phase 1: n = 46, 29%; phase 2: n = 38, 22% e phase 3: n = 13, 15%; p = 0.027) and VASC were observed during the three periods. BE occurred significantly more often in F/M group (F/M: n = 48; 32%; U/M: n = 12, 16%; F/P: n = 18, 21%; U/P: n = 19, 17%; p = 0.008). F/M subgroup was an independent predictor of BE both in multivariable analysis and propensity score matching analysis. Conclusions: The introduction of ultrasound‐guided femoral puncture and percutaneous arterial closure devices has reduced access site bleedings with a progressive improvement after the first 6 months learning period.