Incidence of and predisposing factors for pseudoaneurysm formation in a high-volume cardiovascular center.
<h4>Purpose</h4>To evaluate factors associated with pseudoaneurysm (PSA) development.<h4>Methods</h4>Between January 2016 and May 2020, 30,196 patients had invasive vascular radiological or cardiac endovascular procedures that required arterial puncture. All patients with PSA...
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oai:doaj.org-article:0b820f7996624fbbb7b466d4ddb3d1ea2021-12-02T20:17:38ZIncidence of and predisposing factors for pseudoaneurysm formation in a high-volume cardiovascular center.1932-620310.1371/journal.pone.0256317https://doaj.org/article/0b820f7996624fbbb7b466d4ddb3d1ea2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0256317https://doaj.org/toc/1932-6203<h4>Purpose</h4>To evaluate factors associated with pseudoaneurysm (PSA) development.<h4>Methods</h4>Between January 2016 and May 2020, 30,196 patients had invasive vascular radiological or cardiac endovascular procedures that required arterial puncture. All patients with PSA were identified. A matched (age, gender, and type of the procedure) control group of 134 patients was created to reveal predictors of PSA formation.<h4>Results</h4>Single PSAs were found in 134 patients. Fifty-three PSAs developed after radiological procedures (53/6555 [0.8%]), 31 after coronary artery procedures (31/18038 [0.2%]), 25 after non-coronary artery cardiac procedures (25/5603 [0.4%]), and 25 due to procedures in which the arterial puncture was unintended. Thirty-four PSAs (25.4%) were localized to the upper extremity arteries (vascular closure device [VCD], N = 0), while 100 (74.6%) arose from the lower extremity arteries (VCD, N = 37). The PSA prevalence was 0.05% (10/20478) in the radial artery, 0.1% (2/1818) in the ulnar artery, 1.2% (22/1897) in the brachial artery, and 0.4% (99/22202) in the femoral artery. Treatments for upper and lower limb PSAs were as follows: bandage replacement (32.4% and 14%, respectively), ultrasound-guided compression (11.8% and 1%, respectively), ultrasound-guided thrombin injection (38.2% and 78%, respectively), and open surgery (17.6% and 12%, respectively). Reintervention was necessary in 19 patients (14.2%). The prevalence of PSA for the punctured artery with and without VCD use was 37/3555 (1%) and 97/27204 (0.4%), respectively (OR, 2.94; 95% CI, 1.95-4.34; P<0.001). The effect of red blood cell (RBC) count (P<0.001), hematocrit value (P<0.001), hemoglobin value (P<0.001), international normalized ratio (INR; P<0.001), RBC count-INR interaction (P = 0.003), and RBC count-VCD use interaction (P = 0.036) on PSA formation was significant.<h4>Conclusion</h4>Patients in whom the puncture site is closed with a VCD require increased observation. Preprocedural laboratory findings are useful for the identification of patients at high risk of PSA formation.Hunor SarkadiJudit CsőreDániel Sándor VeresNándor SzegediLevente MolnárLászló GellérViktor BércziEdit DósaPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 8, p e0256317 (2021) |
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Medicine R Science Q Hunor Sarkadi Judit Csőre Dániel Sándor Veres Nándor Szegedi Levente Molnár László Gellér Viktor Bérczi Edit Dósa Incidence of and predisposing factors for pseudoaneurysm formation in a high-volume cardiovascular center. |
| description |
<h4>Purpose</h4>To evaluate factors associated with pseudoaneurysm (PSA) development.<h4>Methods</h4>Between January 2016 and May 2020, 30,196 patients had invasive vascular radiological or cardiac endovascular procedures that required arterial puncture. All patients with PSA were identified. A matched (age, gender, and type of the procedure) control group of 134 patients was created to reveal predictors of PSA formation.<h4>Results</h4>Single PSAs were found in 134 patients. Fifty-three PSAs developed after radiological procedures (53/6555 [0.8%]), 31 after coronary artery procedures (31/18038 [0.2%]), 25 after non-coronary artery cardiac procedures (25/5603 [0.4%]), and 25 due to procedures in which the arterial puncture was unintended. Thirty-four PSAs (25.4%) were localized to the upper extremity arteries (vascular closure device [VCD], N = 0), while 100 (74.6%) arose from the lower extremity arteries (VCD, N = 37). The PSA prevalence was 0.05% (10/20478) in the radial artery, 0.1% (2/1818) in the ulnar artery, 1.2% (22/1897) in the brachial artery, and 0.4% (99/22202) in the femoral artery. Treatments for upper and lower limb PSAs were as follows: bandage replacement (32.4% and 14%, respectively), ultrasound-guided compression (11.8% and 1%, respectively), ultrasound-guided thrombin injection (38.2% and 78%, respectively), and open surgery (17.6% and 12%, respectively). Reintervention was necessary in 19 patients (14.2%). The prevalence of PSA for the punctured artery with and without VCD use was 37/3555 (1%) and 97/27204 (0.4%), respectively (OR, 2.94; 95% CI, 1.95-4.34; P<0.001). The effect of red blood cell (RBC) count (P<0.001), hematocrit value (P<0.001), hemoglobin value (P<0.001), international normalized ratio (INR; P<0.001), RBC count-INR interaction (P = 0.003), and RBC count-VCD use interaction (P = 0.036) on PSA formation was significant.<h4>Conclusion</h4>Patients in whom the puncture site is closed with a VCD require increased observation. Preprocedural laboratory findings are useful for the identification of patients at high risk of PSA formation. |
| format |
article |
| author |
Hunor Sarkadi Judit Csőre Dániel Sándor Veres Nándor Szegedi Levente Molnár László Gellér Viktor Bérczi Edit Dósa |
| author_facet |
Hunor Sarkadi Judit Csőre Dániel Sándor Veres Nándor Szegedi Levente Molnár László Gellér Viktor Bérczi Edit Dósa |
| author_sort |
Hunor Sarkadi |
| title |
Incidence of and predisposing factors for pseudoaneurysm formation in a high-volume cardiovascular center. |
| title_short |
Incidence of and predisposing factors for pseudoaneurysm formation in a high-volume cardiovascular center. |
| title_full |
Incidence of and predisposing factors for pseudoaneurysm formation in a high-volume cardiovascular center. |
| title_fullStr |
Incidence of and predisposing factors for pseudoaneurysm formation in a high-volume cardiovascular center. |
| title_full_unstemmed |
Incidence of and predisposing factors for pseudoaneurysm formation in a high-volume cardiovascular center. |
| title_sort |
incidence of and predisposing factors for pseudoaneurysm formation in a high-volume cardiovascular center. |
| publisher |
Public Library of Science (PLoS) |
| publishDate |
2021 |
| url |
https://doaj.org/article/0b820f7996624fbbb7b466d4ddb3d1ea |
| work_keys_str_mv |
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