A novel, minimally invasive access technique versus standard 18-gauge needle set for femoral access.

MedStar author(s):
Citation: Catheterization & Cardiovascular Interventions. 79(7):1180-5, 2012 Jun 1.PMID: 22334384Institution: MedStar Heart & Vascular InstituteForm of publication: Journal ArticleMedline article type(s): Comparative Study | Journal ArticleSubject headings: *Angioplasty, Balloon, Coronary/is [Instrumentation] | *Catheterization, Peripheral/is [Instrumentation] | *Femoral Artery | *Needles | Age Factors | Aged | Angioplasty, Balloon, Coronary/ae [Adverse Effects] | Catheterization, Peripheral/ae [Adverse Effects] | Chi-Square Distribution | District of Columbia | Equipment Design | Female | Hemorrhage/et [Etiology] | Hemorrhage/pc [Prevention & Control] | Hemostatic Techniques/is [Instrumentation] | Humans | Logistic Models | Male | Middle Aged | Miniaturization | Multivariate Analysis | Odds Ratio | Punctures | Registries | Retrospective Studies | Risk Assessment | Risk Factors | Treatment OutcomeYear: 2012Local holdings: Available online from MWHC library: 1996 - present, Available in print through MWHC library: 1996 - 2006ISSN:
  • 1522-1946
Name of journal: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & InterventionsAbstract: BACKGROUND: Vascular access site complications are the most common problems after PCI. The Micropuncture 21G needle set was recently introduced to minimize such complications.CONCLUSIONS: Femoral access using the Micropuncture technique did not reduce the incidence of vascular complications and the marginally higher than expected retroperitoneal bleeding is based on very small numbers. The routine use of the Micropuncture set and its technique should be revisited. Copyright 2012 Wiley Periodicals, Inc.METHODS: A cohort of 3,243 consecutive patients was studied. Patients receiving thrombolytics, IIb/IIIa antagonist, coumadin, or intra-aortic balloon pump were excluded. Micropuncture access was used in 544 patients and standard 18G needle in 2,699. All access sites were managed with a vascular closure device. Primary endpoints included vascular perforation or limb ischemia requiring repair, retroperitoneal bleeding, pseudoaneurysm, arteriovenous fistula, and groin hematoma (>4 cm).OBJECTIVE: To compare access site complications with the Micropuncture 21 gauge (G) needle set to the standard 18G needle in patients undergoing percutaneous coronary intervention (PCI) using the femoral approach.RESULTS: Patients undergoing PCI with Micropuncture were at higher risk: they were older (65.9 +/- 9 vs. 64.7 +/- 11.8, P = 0.03); had lower body surface area (1.9 +/- 0.2 vs. 2.0 +/- 0.3, P = 0.02); more prevalent peripheral vascular disease [119 (21.9%) vs. 380 (14.1%), P < 0.001] and renal failure [106 (19.6%) vs. 318 (11.8%), P < 0.001]. Overall, there was no significant difference in the access site complications rate using Micropuncture vs. standard needle, 7 (1.3%) vs. 27 (1.0%), respectively, P = 0.54. The Micropuncture group had significantly higher retroperitoneal bleeding, 0.7% vs. 0.18%, P = 0.04. After multivariable adjustment, only age remained significantly associated with vascular complications (OR 1.03, P = 0.04).All authors: Ben-Dor I, Bernardo N, Lindsay J, Mahmoudi M, Maluenda G, Pichard AD, Satler LF, Torguson R, Waksman R, Xue ZFiscal year: FY2012Digital Object Identifier: Date added to catalog: 2013-09-17
Holdings
Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 22334384 Available 22334384

Available online from MWHC library: 1996 - present, Available in print through MWHC library: 1996 - 2006

BACKGROUND: Vascular access site complications are the most common problems after PCI. The Micropuncture 21G needle set was recently introduced to minimize such complications.

CONCLUSIONS: Femoral access using the Micropuncture technique did not reduce the incidence of vascular complications and the marginally higher than expected retroperitoneal bleeding is based on very small numbers. The routine use of the Micropuncture set and its technique should be revisited. Copyright 2012 Wiley Periodicals, Inc.

METHODS: A cohort of 3,243 consecutive patients was studied. Patients receiving thrombolytics, IIb/IIIa antagonist, coumadin, or intra-aortic balloon pump were excluded. Micropuncture access was used in 544 patients and standard 18G needle in 2,699. All access sites were managed with a vascular closure device. Primary endpoints included vascular perforation or limb ischemia requiring repair, retroperitoneal bleeding, pseudoaneurysm, arteriovenous fistula, and groin hematoma (>4 cm).

OBJECTIVE: To compare access site complications with the Micropuncture 21 gauge (G) needle set to the standard 18G needle in patients undergoing percutaneous coronary intervention (PCI) using the femoral approach.

RESULTS: Patients undergoing PCI with Micropuncture were at higher risk: they were older (65.9 +/- 9 vs. 64.7 +/- 11.8, P = 0.03); had lower body surface area (1.9 +/- 0.2 vs. 2.0 +/- 0.3, P = 0.02); more prevalent peripheral vascular disease [119 (21.9%) vs. 380 (14.1%), P < 0.001] and renal failure [106 (19.6%) vs. 318 (11.8%), P < 0.001]. Overall, there was no significant difference in the access site complications rate using Micropuncture vs. standard needle, 7 (1.3%) vs. 27 (1.0%), respectively, P = 0.54. The Micropuncture group had significantly higher retroperitoneal bleeding, 0.7% vs. 0.18%, P = 0.04. After multivariable adjustment, only age remained significantly associated with vascular complications (OR 1.03, P = 0.04).

English

Powered by Koha