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. 2021 Feb;83(1):125-133.
doi: 10.18999/nagjms.83.1.125.

Case-control study of postprocedural arterial puncture site hemorrhage after neuroendovascular treatment

Yosuke Tamari  1 , Takashi Izumi  1 , Masahiro Nishihori  1 , Tasuku Imai  1 , Masashi Ito  1 , Tetsuya Tsukada  1 , Mamoru Ishida  1 , Toshihiko Wakabayashi  1
Affiliations

Case-control study of postprocedural arterial puncture site hemorrhage after neuroendovascular treatment

Yosuke Tamari et al. Nagoya J Med Sci. 2021 Feb.

Abstract

Puncture site hemorrhage following femoral artery catheterization is a significant cause of morbidity. The aim of this case-control study was to identify predictors of postprocedural arterial hemorrhage at the puncture site. We retrospectively reviewed 255 patients who underwent endovascular treatment at our institution over a 23-month period and classified them into a hemorrhage group and a non-hemorrhage group. Puncture site hemorrhage occurred in 15 patients (5.9%). Clinical factors associated with a significantly increased risk of puncture site bleeding included patients whose postoperative activated clotting time of ≥300 seconds before removal of the sheath (9 patients, 11.8%; P<0.05), those who received triple antiplatelet therapy (n=4, 17.4%; P<0.05) and the group administered heparin postoperatively (7 patients, 13.2%; P<0.05). The effects of low on-treatment platelet reactivity, i.e., P2Y12 reaction units <95%, sheath size, hemostasis method used, and operating time were not clinically significant. Our findings suggest an increased risk of puncture site hemorrhage in patients who either had an activated clotting time ≥300 seconds before the postoperative removal of the sheath, had received triple antiplatelet therapy, or were administered heparin postoperatively.

Keywords: anticoagulant; complications; femoral approach; neuroendovascular therapy; puncture site hemorrhage.

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Conflict of interest statement

None of the authors have any conflicts of interest to declare in relation to this work.

References

    1. Sato M, Matsumaru Y, Sakai N, Yoshimura S, JR-NET Study Group Affiliations. Detailed analysis of puncture site vascular complications in Japanese Registry of Neuroendovascular Therapy (JR-NET) and JR-NET2. Neurol Med Chir (Tokyo). 2014;54 Suppl 2:17–22. - PubMed
    1. Upponi SS, Ganeshan AG, Warakaulle DR, Phillips-Hughes J, Boardman P, Uberoi R. Angioseal versus manual compression for haemostasis following peripheral vascular diagnostic and interventional procedures--a randomized controlled trial. Eur J Radiol. 2007;61(2):332–334. doi: 10.1016/j.ejrad.2006.09.007. - DOI - PubMed
    1. Starnes BW, O’Donnell SD, Gillespie DL, et al. Percutaneous arterial closure in peripheral vascular disease: a prospective randomized evaluation of the Perclose device. J Vasc Surg. 2003;38(2):263–271. doi: 10.1016/s0741-5214(03)00291-x. - DOI - PubMed
    1. Wong SC, Bachinsky W, Cambier P, et al. A randomized comparison of a novel bioabsorbable vascular closure device versus manual compression in the achievement of hemostasis after percutaneous femoral procedures the ECLPISE (Ensure’s Vascular Closure Device Speeds Hemostasis Trial). JACC Cardiovasc Interv. 2009;2(8):785–793. doi: 10.1016/j.jcin.2009.06.006. - DOI - PubMed
    1. Das R, Ahmed K, Athanasiou T, Morgan RA, Belli AM. Arterial closure devices versus manual compression for femoral haemostasis in interventional radiological procedures: a systematic review and meta-analysis. Cardiovasc Intervent Radiol. 2011;34(4):723–738. doi: 10.1007/s00270-010-9981-0. - DOI - PubMed

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