Forearm hematoma as a complication of transradial coronary intervention: an Indian single-center experience.
Coronary angiography
forearm hematoma
percutaneous coronary intervention
transradial coronary intervention
Journal
American journal of cardiovascular disease
ISSN: 2160-200X
Titre abrégé: Am J Cardiovasc Dis
Pays: United States
ID NLM: 101569582
Informations de publication
Date de publication:
2021
2021
Historique:
received:
26
06
2021
accepted:
14
08
2021
entrez:
22
9
2021
pubmed:
23
9
2021
medline:
23
9
2021
Statut:
epublish
Résumé
Forearm hematomas are not uncommon after transradial coronary interventions. The present study describes the incidence and predictors of forearm hematoma formation after transradial coronary interventions. This was a prospective study in 1754 patients undergoing angiography/angioplasty through transradial access. Each procedure was performed using optimum levels of anticoagulation, hydrophilic sheaths, and post-procedural patent hemostasis protocols. Patients were evaluated for forearm hematoma immediately after the procedure, after radial band removal, and on the next day of the procedure. Severity of hematomas was graded according to the Early Discharge after Transradial Stenting of Coronary Arteries Study scale. Univariate and multivariate logistic regression analyses were done to determine the predictors of hematoma formation. Mean age of the patients was 56.31 years and 82.2% were males. A total of 1374 (78.3%) patients underwent angioplasty while 380 (21.7%) underwent angiography. Forearm hematoma developed in 187 (10.7%) patients. Grade I hematoma was most common (3.53%) followed by Grade II (3.08%), Grade III (2.83%) and Grade IV (1.25%) hematoma. None of the patients required vascular or surgical interventions for this complication. Female gender, multiple puncture attempts, intensive antiplatelet therapy, complex procedure and longer hemostasis time were significant predictors of forearm hematoma formation post transradial coronary interventions. Forearm hematoma developed in substantial proportion of patients undergoing transradial coronary interventions and interventional variables were predominantly associated with hematoma formation. Pre-emptive knowledge of modifiable interventional risk factors can help in reducing the burden of this complication.
Sections du résumé
BACKGROUND
BACKGROUND
Forearm hematomas are not uncommon after transradial coronary interventions. The present study describes the incidence and predictors of forearm hematoma formation after transradial coronary interventions.
METHODS
METHODS
This was a prospective study in 1754 patients undergoing angiography/angioplasty through transradial access. Each procedure was performed using optimum levels of anticoagulation, hydrophilic sheaths, and post-procedural patent hemostasis protocols. Patients were evaluated for forearm hematoma immediately after the procedure, after radial band removal, and on the next day of the procedure. Severity of hematomas was graded according to the Early Discharge after Transradial Stenting of Coronary Arteries Study scale. Univariate and multivariate logistic regression analyses were done to determine the predictors of hematoma formation.
RESULTS
RESULTS
Mean age of the patients was 56.31 years and 82.2% were males. A total of 1374 (78.3%) patients underwent angioplasty while 380 (21.7%) underwent angiography. Forearm hematoma developed in 187 (10.7%) patients. Grade I hematoma was most common (3.53%) followed by Grade II (3.08%), Grade III (2.83%) and Grade IV (1.25%) hematoma. None of the patients required vascular or surgical interventions for this complication. Female gender, multiple puncture attempts, intensive antiplatelet therapy, complex procedure and longer hemostasis time were significant predictors of forearm hematoma formation post transradial coronary interventions.
CONCLUSIONS
CONCLUSIONS
Forearm hematoma developed in substantial proportion of patients undergoing transradial coronary interventions and interventional variables were predominantly associated with hematoma formation. Pre-emptive knowledge of modifiable interventional risk factors can help in reducing the burden of this complication.
Types de publication
Journal Article
Langues
eng
Pagination
462-470Informations de copyright
AJCD Copyright © 2021.
Déclaration de conflit d'intérêts
None.
Références
Circ Cardiovasc Interv. 2019 Sep;12(9):e008045
pubmed: 31514524
Indian Heart J. 2019 Mar - Apr;71(2):136-142
pubmed: 31280825
Am Heart J. 2009 Apr;157(4):740-5
pubmed: 19332204
Int J Cardiol Heart Vasc. 2016 Dec 29;14:46-52
pubmed: 28616563
JACC Cardiovasc Interv. 2018 Nov 26;11(22):2241-2250
pubmed: 30391389
J Am Coll Cardiol. 1998 Sep;32(3):572-6
pubmed: 9741495
Catheter Cardiovasc Interv. 2021 Jun 1;97(7):1369-1376
pubmed: 32761864
Cureus. 2019 Dec 27;11(12):e6484
pubmed: 32025407
Indian Heart J. 2013 Jul-Aug;65(4):378-87
pubmed: 23992998
Circulation. 2006 Dec 12;114(24):2636-43
pubmed: 17145988
Cardiovasc Interv Ther. 2016 Apr;31(2):147-50
pubmed: 25855327
Catheter Cardiovasc Interv. 2008 Sep 1;72(3):335-340
pubmed: 18726956
Indian Heart J. 2015 May-Jun;67(3):275-81
pubmed: 26138190
Int J Cardiol. 1998 May 15;64(3):231-9
pubmed: 9672402
Tex Heart Inst J. 2017 Feb 1;44(1):73-76
pubmed: 28265219
JACC Cardiovasc Interv. 2009 Nov;2(11):1047-54
pubmed: 19926042
J Invasive Cardiol. 2009 Oct;21(10):544-7
pubmed: 19805845