Outcome of access site in patients treated with platelet glycoprotein IIb/IIIa inhibitors in the era of closure devices

Abid R. Assali, Stefano Sdringola, Ali Moustapha, Mohammad Ghani, Joseph Salloum, George Schroth, Ken Fujise, H. Vernon Anderson, Richard W. Smalling, Oscar R. Rosales

Research output: Contribution to journalArticle

47 Scopus citations

Abstract

The most consistent procedural predictor of vascular access site complications thus far has been the intensity and duration of anticoagulant therapy during and after percutaneous coronary interventions (PCI). Several devices have been developed to aid in the closure of the femoral arteriotomy. This report describes the clinical outcome of unsuccessful deployment of femoral closure devices in a cohort of 285 consecutive patients who underwent PCI and were treated with platelet glycoprotein (GP) IIb/IIIa inhibitors. Manual femoral artery compression was used in 123 patients, Perclose in 123 patients, and AngioSeal in 39 patients. Successful homeostasis was achieved in 98.4% of patients who received manual compression, in 91.9% of the Perclose-sealed arteriotomy, and in 84.6% of patients who received the AngioSeal closure device (P = 0.004). The incidence of vascular complications after successful deployment was 9%. Patients not achieving hemostasis with closure device or 1° manual compression developed complications in the majority of cases (> 80%; P < 0.05). By multivariate analysis (with adjustment for baseline differences), the use of AngioSeal closure device was found to be an independent risk factors leading to primary deployment failure and all access site complications (OR 2.97; 95% Cl 1.5-6.0; P = 0.006). In summary, failed hemostasis by artery closure devices in patients undergoing PCI who are treated with GP IIb/IIIa inhibitors is associated with significant vascular complications. AngioSeal may be associated with a higher failure rate, while manual compression and Perclose seem to be more effective with a lower complication rate.

Original languageEnglish (US)
Pages (from-to)1-5
Number of pages5
JournalCatheterization and Cardiovascular Interventions
Volume58
Issue number1
DOIs
StatePublished - Jan 1 2003

Keywords

  • Femoral closure device
  • GP IIb/IIIa inhibitors
  • Vascular access complication

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Outcome of access site in patients treated with platelet glycoprotein IIb/IIIa inhibitors in the era of closure devices'. Together they form a unique fingerprint.

  • Cite this

    Assali, A. R., Sdringola, S., Moustapha, A., Ghani, M., Salloum, J., Schroth, G., Fujise, K., Anderson, H. V., Smalling, R. W., & Rosales, O. R. (2003). Outcome of access site in patients treated with platelet glycoprotein IIb/IIIa inhibitors in the era of closure devices. Catheterization and Cardiovascular Interventions, 58(1), 1-5. https://doi.org/10.1002/ccd.10384