Risk Factors for Postoperative Puncture Site Bleeding after Interventional Treatment of Cerebrovascular Disease via Common Femoral Artery Puncture: A Retrospective Analysis of 710 Cases.

This study aimed to identify the risk factors associated with puncture site bleeding following percutaneous puncture of the common femoral artery during interventional treatment of cerebrovascular disease (CVD). A retrospective analysis was conducted on 710 patients who underwent interventional treatment for CVD via femoral artery puncture. Among them, 26 individuals (3.66%) experienced bleeding at the femoral artery puncture site. Binary logistic regression analysis was performed to identify risk factors for puncture site bleeding. The impact of salt bag compression on postoperative bleeding was evaluated in patients with intermediate to high bleeding risk scores. The bleeding group showed higher blood pressure, lower platelet counts, longer prothrombin time and activated partial thromboplastin time, as well as a higher prevalence of larger vascular sheath sizes and variations in the timing of anti-coagulant and anti-platelet therapy administration. The bleeding risk score was higher in the bleeding group, indicating its predictive value for bleeding risk. Higher bleeding risk score, unstable blood pressure, repeated puncture, and serious vascular conditions were significant risk factors for puncture site bleeding. Application of salt bag compression for a duration of 2 hours reduced postoperative puncture site bleeding in patients with intermediate to high bleeding risk scores. Our study identified several significant risk factors for puncture site bleeding after cerebral vascular intervention via femoral artery puncture, including the bleeding risk score, blood pressure, repeated puncture, and vascular conditions. Implementing salt bag compression as a preventive measure can help mitigate bleeding complications in these high-risk patients.

A novel femoral artery compression device (butterfly compress) versus manual compression for hemostasis after femoral artery puncture: a randomized comparison.

OBJECTIVE: This study aimed to investigate the hemostatic efficacy of a novel femoral artery compression device in patients undergoing an interventional procedure through femoral artery puncture. MATERIAL AND METHODS: Patients enrolled in this trial were randomly assigned 1:1 to the novel femoral artery compression device (NFACD) or the manual compression (MC) group. The primary endpoints were time to hemostasis (TTH), time to ambulation (TTA), any other complications, such as the occurrence of hematoma, bleeding, pseudoaneurysm and arteriovenous fistula at the puncture site, and time to hospital discharge. RESULTS: A total of 617 patients were included in this study (NFACD, n = 308 versus MC, n = 309) from May 2017 to September 2019, and the baseline characteristics of the groups were similar. We found that the TTH and TTA were significantly shorter in the NFACD group than in the MC group (4.4 ± 11.6 min vs. 20.1 ± 22.5 min; p < 0.001; 8.9 ± 14.2 h vs. 16.3 ± 27.5 h; p = 0.002). There were few other complications in either group. In addition, there was no significant difference in time to hospital discharge between the NFACD group and the MC group. CONCLUSION: The novel femoral artery compression device is effective in achieving hemostasis in patients undergoing femoral artery puncture and is associated with a marked shortening of the TTH and TTA.

The efficacy of the figure-of-eight suture technique in the treatment of tunnel bleeding of the femoral artery route after percutaneous coronary intervention or angiography.

OBJECTIVE: To evaluate the efficacy of the figure-of-eight (FOE) suture technique in the treatment of tunnel bleeding after femoral artery puncture compared with manual compression (MC). METHODS: This prospective, randomized, controlled study enrolled patients that had received transfemoral coronary artery angiography or percutaneous coronary intervention and then developed tunnel bleeding. They were randomly assigned into two groups: FOE suture group (ES group) and manual compression group (MC group). Total treatment time, performance frequency, performance time, rate of deep vein thrombosis (DVT) and in-hospital time after the procedure were compared. RESULTS: A total of 152 patients were enrolled in the study (ES group, n = 63; MC group, n = 89). Compared with the MC group, the total treatment time (mean ± SD: ES 22.3 ± 5.4 h versus MC 26.8 ± 6.8 h), performance frequency (mean ± SD: ES 2.1 ± 0.7 versus MC 2.6 ± 1.1), performance time (mean ± SD: ES 8.9 ± 2.5 min versus MC 12.3 ± 4.1 min), in-hospital time after the procedure (mean ± SD: ES 3.5 ± 1.2 days versus MC 4.8 ± 2.1 days) and DVT rate (ES 0.0% versus MC 6.7%) were significantly lower in the ES group. CONCLUSION: The FOE suture technique effectively treated tunnel bleeding after femoral artery puncture.

Scrotal hematoma following femoral artery puncture.

The scrotum hematoma following femoral artery puncture is a rare complication. The bleeding from the puncture site drained through the inguinal canal into the scrotum. The present case may indicate the importance of quick observation of the scrotum, when the puncture of femoral artery was performed.

Application of relay puncture technique in treating patients with complicated lower extremity arterial diseases.

OBJECTIVE: This study aimed to introduce and evaluate the safety and efficacy of the relay puncture technique in patients with complicated lower extremity arterial diseases. METHODS: A total of 21 patients (16 male and five female patients; median age: 68.5 years old), who had suffered from lower extremity arterial diseases between December 2014 and July 2017, were retrospectively collected. For all patients, the contralateral femoral artery was not available for puncture access, and the length of the devices was too short for the brachial artery approach. Therefore, the relay puncture technique, in which the first puncture was performed on the brachial artery, followed by an antegrade puncture on the femoral artery, was used to accomplish the endovascular therapy. Percutaneous transluminal angioplasty and/or percutaneous transluminal stenting were/was used to assess the efficacy of the relay puncture technique. The ankle-brachial index (ABI) and Rutherford clinical classification were used to evaluate the improvement of symptoms after treatment. Patients were followed up for 1, 3, 6, and 12 months, and annually (mean: 16.6 months) after discharge. RESULTS: The relay puncture treatment had a 100% technical success rate, and immediately decreased the ischemic symptoms of patients after the procedure. The ABI significantly increased from 0.33 ± 0.18 to 0.75 ± 0.21 at the 1-year follow-up time point (P < 0.05). No serious complications occurred during the follow-up period. The 1-year primary patency rate was 71.43%. CONCLUSION: The relay puncture technique is a feasible technique in the hands of experienced and skilled equipment operators for the treatment of lower extremity arterial diseases, when the contralateral femoral artery is not available for puncture, and the length of the device is too short to treat the distal lesion of the femoral artery and popliteal artery through the brachial artery approach.

Retrograde catheterization via superficial femoral artery for the treatment of ipsilateral superficial femoral artery occlusive disease:its clinical application / 中国医师进修杂志

Objective To investigate the clinical application and value of retrograde catheterization via superficial femoral artery for the treatment of limb chronic total occlusive disease (CTO). Methods Fifty-nine patients with proximal and middle occlusive lesions of superficial femoral artery from Jan. 2013 to Jan. 2015 in department of emergency surgery were retrospectively analyzed. Percutaneous transluminal angioplasty (PTA) together with stent implantation was performed to reopen the all narrowed or obstructed superficial femoral artery.Seventeen patients received ipsilateral retrograde catheterization via superficial femoral artery together. The length of the diseased artery ranged from 6.5 to 13.4 cm, with a mean of (8.3 ± 2.9) cm, including right (11 cases)and left (8 cases) femoral arteries. After the interventional therapy patients were followed up for 1- 24 months. Results All patients were treated successfully. The proximal and middle occlusive lesions of superficial femoral artery were reopened.No serious complications were found including nerve and vessel damage+After the treatment, the ischemic symptoms were markedly improved or even disappeared. In 14/19 of patients the superficial femoral arteries remained patent during the follow-up period. The ankle preoperative brachial index (ABI) was 0.20 to 0.51 (0.39 ± 0.06), while the postoperative ABI was 0.65 to 1.15 (0.74 ± 0.13). The difference in ABI between pre-operation and post-operation was statistically significant (P<0.05). Conclusions Retrograde catheterization via superficial femoral artery is an effective alternative to treat proximal and middle occlusion of ipsilateral superficial femoral artery. It has high successful rate and safety.

Efficacy of transradial approach in the treatment of acute myocardial infarction with direct coronary intervention and its influence on inflammatory factors / 中国医师进修杂志

Objective To investigate the efficacy of transradial approach in the treatment of acute myocardial infarction (AMI) with direct coronary intervention and its influence on inflammatory factors. Methods One hundred and forty-six patients with acute ST elevation myocardial infarction were randomly divided into radial artery group and femoral artery group with 73 cases in each group. The patients in radial artery group received transradial percutaneous coronary intervention (PCI) by transradial approach, and those in the femoral artery group were treated with PCI by transfemoral approach. The operation time, puncture to balloon opening time, X-ray exposure time, contrast agent dosage, the success rate of PCI, reperfusion arrhythmia, perioperative complication rate, hospitalization time, the incidence of major adverse cardiac events in 3 months and the levels of necrosis factor alpha (TNF-alpha), high sensitive C reactive protein (hs-CRP) at preoperative and postoperative 12 h, postoperative 3 d and 7d were observed and compared between two groups. Results The operation time,puncture to balloon opening time, X-ray exposure time, PCI rate, the incidence of reperfusion arrhythmias in two groups had no significant differences (P > 0.05). The incidences of perioperative complications and hospitalization time in radial artery group were significantly shorter than those in femoral artery group: 5.48%(4/73) vs. 28.77%(21/73), (7.83 ± 1.13) d vs.(9.74 ± 1.57) d, P<0.05. The levels of TNF-αand hs-CRP in two groups before operation had no significant difference (P>0.05). The levels of TNF-αand hs-CRP in two groups 12 h after operation were significant increased (P<0.05), and gradually decreased 3 d and 7 d after operation. The levels of TNF-αand hs-CRP in two groups had no significant differences (P>0.05). The incidence of major adverse cardiac events in 3 months in two groups had no significant difference (P>0.05). Conclusions Transradial approach by skilled physicians in the treatment of acute ST segment elevation myocardial infarction has the same safety and feasibility compared with femoral artery approach, and can reduce the incidence of postoperative complications and hospitalization time.It has a certain clinical advantages, and it is worthy of popularization and application.

Efficacy of transradial approach in the treatment of acute myocardial infarction with direct coronary intervention and its influence on inflammatory factors / 中国医师进修杂志

Objective To investigate the efficacy of transradial approach in the treatment of acute myocardial infarction (AMI) with direct coronary intervention and its influence on inflammatory factors. Methods One hundred and forty-six patients with acute ST elevation myocardial infarction were randomly divided into radial artery group and femoral artery group with 73 cases in each group. The patients in radial artery group received transradial percutaneous coronary intervention (PCI) by transradial approach, and those in the femoral artery group were treated with PCI by transfemoral approach. The operation time, puncture to balloon opening time, X-ray exposure time, contrast agent dosage, the success rate of PCI, reperfusion arrhythmia, perioperative complication rate, hospitalization time, the incidence of major adverse cardiac events in 3 months and the levels of necrosis factor alpha (TNF-alpha), high sensitive C reactive protein (hs-CRP) at preoperative and postoperative 12 h, postoperative 3 d and 7d were observed and compared between two groups. Results The operation time,puncture to balloon opening time, X-ray exposure time, PCI rate, the incidence of reperfusion arrhythmias in two groups had no significant differences (P > 0.05). The incidences of perioperative complications and hospitalization time in radial artery group were significantly shorter than those in femoral artery group: 5.48%(4/73) vs. 28.77%(21/73), (7.83 ± 1.13) d vs.(9.74 ± 1.57) d, P<0.05. The levels of TNF-αand hs-CRP in two groups before operation had no significant difference (P>0.05). The levels of TNF-αand hs-CRP in two groups 12 h after operation were significant increased (P<0.05), and gradually decreased 3 d and 7 d after operation. The levels of TNF-αand hs-CRP in two groups had no significant differences (P>0.05). The incidence of major adverse cardiac events in 3 months in two groups had no significant difference (P>0.05). Conclusions Transradial approach by skilled physicians in the treatment of acute ST segment elevation myocardial infarction has the same safety and feasibility compared with femoral artery approach, and can reduce the incidence of postoperative complications and hospitalization time.It has a certain clinical advantages, and it is worthy of popularization and application.

Comparison of Curative Effects and Complications of Coronary Intervention through Radial Artery and Femoral Artery / 昆明医科大学学报

Objective To observe the clinical effects and complications of coronary intervention through radial artery and femoral artery.Methods A hundred and sixty patients received coronary intervention treatment or coronary angiogram in the Second Affiliated Hospital of Bengbu Medical College from March 2010 to March 2015 were enrolled in this study.The patients were divided into radial artery puncture group (n =80),who received radial artery puncture and femoral artery puncture group (n =80) who received femoral artery puncture.The general date such as puncture time,intervention success rate,time in bed,postpuncture compression time and complications such as postoperative bleeding,arterial occlusion and postoperative untoward reactions were recorded and compared.Results The intervention success rate of radial artery puncture group was 90.0％ lower than that of femoral artery puncture group (97.5％),with statistically significant differences (P＜0.05).The puncture time,postpuncture compression time,time in bed and hospital stays of radial artery puncture group were significantly shorter than those of femoral artery puncture group (P ＜0.01).As for complications,the incidences of postpuncture bleeding and vagus nerve reflex in radial artery puncture group were significantly lower than that in femoral artery puncture group (P＜0.05).As for postoperative untoward reactions,the incidences of irritable and insomnia,uroschesis,pain caused by puncture,local skin injure,back pain in radial artery puncture group were significantly lower than those in femoral artery puncture group (P＜0.01).Conclusion With the advantages of mini-invasion,such as shorter time in bed and hospital stays,lower complications and untoward reactions rates,coronary intervention through radial artery is worth of clinical application.

Preventative effects of prostaglandin E1 in combination with iodized olive oil on liver fibrosis after transcatheter arterial chemoembolization in a rabbit model of CCl4-induced liver fibrosis.

To explore the preventative effects of prostaglandin E1 (PGE1) on a rabbit model of CCl4-induced liver fibrosis after transcatheter arterial chemoembolization (TACE), we generated a rabbit model of CCl4-induced liver fibrosis by treatment with 40% CCl4 in iodized olive oil for 16 weeks. Body mass and serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total protein (TP), albumin (ALB), albumin:globulin ratio (A:G), total bilirubin (TBIL), and direct bilirubin (DBIL) were measured. After TACE, the levels of hyaluronic acid (HA), procollagen III (PC III), laminin (LN), and collagen IV (IV-C) were measured, and the severity of liver fibrosis as well as the morphology of liver tissues were determined. Body mass in the model group was significantly decreased from 10 to 16 weeks, and the serum levels of ALT, AST, TP, TBIL, and DBIL levels were significantly increased while the model was being generated; the levels of ALB and A:G were significantly decreased. After TACE, serum levels of HA, PC III, and LN in the group injected with 1.0 mL iodized olive oil (Group B) were higher than in the group that were injected with 1.0 mL iodized olive oil + 0.2 mL PGE1 (Group C), whereas the serum levels of IV-C were lower. The severity of liver fibrosis was ameliorated in Group C. The combination of PGE1 and iodized olive oil prevented the development of liver fibrosis following TACE.

Pocket-size imaging devices allow for reliable bedside screening for femoral artery access site complications.

The aim of this study was to validate pocket-size imaging devices (PSIDs) as a fast screening tool for detecting complications after femoral artery puncture. Forty patients undergoing femoral artery puncture for arterial access related to percutaneous coronary intervention were enrolled. Twenty-four hours after percutaneous coronary intervention, the involved inguinal region was assessed with PSIDs enabling 2-D gray-scale and color Doppler imaging. Subsequently, examination with a stationary high-end ultrasound system was performed to verify the findings of bedside examination in all patients. In 37 patients, PSID imaging had good diagnostic quality. False aneurysms (one asymptomatic) occurred in four patients, and all were recognized during bedside screening with PSID. One case of femoral artery thrombosis was confirmed with PSID and during standard ultrasonographic examination. Physical examination augmented with the quick bedside PSID examination had a sensitivity of 100% and specificity of 91%. PSID facilitated rapid bedside detection of serious access site complications in the vast majority of patients, including asymptomatic cases.

Percutaneous vascular closure using an anchored collagen plug provides effective haemostasis following both antegrade and retrograde femoral arterial punctures.

OBJECTIVES: Small published series suggest a higher failure rate for Angio-Seal vascular closure device (VCD) deployment after antegrade femoral puncture, despite the need for shorter haemostasis times, early discharge, and possibly higher turnover. We seek to compare the deployment efficacy and complications of the Angio-Seal VCD between antegrade and retrograde femoral arterial deployments. METHODS: Radiological data was retrospectively analysed from prospective databases from the hospitals' Computerised Radiology Information System (CRIS) over 2010-2012. Angio-Seal gauge, Rutherford class (as applicable), puncture mode (used to classify deployment as antegrade/retrograde), sheath sizes, and deployment success/failures were recorded. Numerical/statistical analyses were undertaken using Microsoft Excel 10/SISA software. RESULTS: A total of 519 Angio-Seal VIP VCDs were deployed in 470 patients over 2010-2012 (13 other patients could not be analysed due to incomplete data). Sheath sizes for antegrade/retrograde femoral puncture were 5F, n = 22/9; 6F, n = 244/223; 7F, n = 1/5; 9F, n = 4/0. 8F Angio-Seal VIPs were used for 9F punctures only, 6F for the remainder. The overall deployment success rate was 93.7%. In total, 247 (91.1%) successful antegrade deployments were undertaken with 24 (8.9%) failures, compared with 229 (96.6%) successful retrograde deployments with eight (3.4%) failures. Antegrade/retrograde failures were classed as failure to deploy, n = 15/5; bleeding despite successful deployment requiring supplementary compression, n = 6/1; haematoma formation, n = 2/1; groin pain, n = 0/1; vessel stenosis, n = 1/0. Higher deployment failures were noted with antegrade deployment (p < .02, chi-square test). CONCLUSIONS: Angio-Seal deployment is successful for both antegrade/retrograde femoral punctures albeit with a higher antegrade failure rate.

The effect of 3M Tegaderm transparent film on prevention of puncture complications in patients underwent aortocranial angiography via the femoral artery / 中国医师进修杂志

Objective To explore the effect of 3M Tegaderm transparent film on prevention of puncture complications in patients underwent aortocranial angiography via the femoral artery.Methods A retrospective analysis was carried out on 200 patients underwent aortocranial angiography via the femoral artery from February 2012 to February 2014.Eighty patients without using the transparent dressing paste were as the control group,and other 120 patients using 3M Tegaderm transparent film for fixation of arterial sheath were as the observation group.The occurrences of complications,such as arterial sheath breakage,angiographic tube breakage,femoral artery spasm,bruises at the puncture site and subcutaneous hematoma were analyzed,and the feasibility and effectiveness of 3M Tegaderm transparent film for fixation of arterial sheath were assessed.Results The incidence rate of arterial sheath breakage,angiographic tube breakage,femoral artery spasm,bruises at the puncture site and subcutaneous hematoma were significantly reduced in observation group compared with those in control group [5.8％ (7/120) vs.26.2％ (21/80)] (P ＜ 0.05).Conclusion Application of 3M Tegaderm transparent film with a low price and good security for fixation of femoral artery sheath can effectively reduce the occurrence of complications related to femoral artery puncture,which is worthy of wide spreading.

Influence of early ambulation on comfort and postoperative complications for patients with femoral artery interventional therapy: a Meta-analysis / 中国实用护理杂志

Objective To study the influence of the early ambulation on postoperative patients' comfort and complications with the femoral artery puncture interventional therapy.Methods After searching for related literatures with computer,we evaluated the quality of the literatures and screened them.12 random controlled trials met the inclusion criterion.Using RevMan 5.1.2 software,we respectively made Meta analysis for patients with sense of comfort and complications after operations.Results Compared with the control groups,the experimental groups were better in back pain,abdominal pain,limb numbness and acid bilges,sleep disorder,dysuria and urinary retention than those of the control groups.And the difference in the site of puncture bleeding and hematoma had no statistical significance between the two groups.Conclusions It can improve comfort for patients without increasing incidence rate of complications by lying in bed and rest for 12 hours after interventional therapy.It reflects the patient-centered nurs-ing service concept and can improve the patients' quality of life.

Application of prospective risk nursing measures in reducing the occurrence of postoperative local hematoma at femoral artery puncture site / 介入放射学杂志

Objective To discuss the application of prospective risk nursing measures in reducing the occurrence of postoperative local hematoma at femoral artery puncture site. Methods A total of 605 patients receiving femoral artery puncture for interventional management were collected as the control group , and 322 patients were used as the intervention group. The risk factors causing postoperative local hematoma at femoral artery puncture site in the control group were recorded, and based on which risk estimation survey table was designed. According to risk estimation survey, the prospective intervention measures, including risk assessment, standardization of professional training, individual health education, the improvement of care appliance, etc. were carried out for the patients of the intervention group. The occurrences of postoperative local hematoma at femoral artery puncture site were recorded and the results were compared between the two groups. Results No statistically significant differences in demographic and clinical data existed between the two groups. However, the incidence of hematoma in the intervention group was significantly lower than that in the control group (χ2 = 4.652, P < 0.05), although the difference in the severity of hematoma was not significant between the two groups. Conclusion The use of prospective risk nursing measures can effectively reduce the incidence of postoperative hematoma at femoral artery puncture site.

Effectiveness of compressing hemostasis after femoral artery puncture and encheiresis / 中国医师进修杂志

Objective To study the hemostnsis effects of compression cords oppressing after femoral artery puncture and encheiresis. Methods Self-made compression cords were used to stop bleeding of femoral artery puncture sites in 2164 patients underwent 3046 cases of arteriopuncture encheiresis. The total eases were divided into group A (1482 eases) and group B (1564 cases) according to different treatment of oppression and breaking duration which were 8-10 hours for group A and 5-6 hours for group B, the hemostasis effects, discomfortableness and related complications within two groups were evaluated. Results The proportion of patients who got good hemostasis effects were 99.2% in group A, 99.0% in group B. There was no difference in hemostasis effects between two groups (P> 0.05). While the rate of discomfortableness in group A (63.8%) was higher than that in group B(42.9%) (P<0.05). The related serious complications were 2 patients in group A, but no occurred in group B. Conclusion Self-made compression cords op- pressing and 5-6 hours breaking time course can achieve both finer hemostasis effect and lower frequency of complications after femoral artery puncture and encheiresis.

A research about the methods of hemostasis by compression after femoral artery puncture for hemodialysis patients / 中国实用护理杂志

Objective To study the proper method of hamotasis by compression after femoral artery puncture for hemodialysis patients, and then decline the incidence rate of complication. Methods There were 107 hemodialysis patients in the observation group and 106 patients were in the control group. The method of using hard board paper press the point of puncture was adopted in the observation group, the traditional method was used in the control group. Compare the incidence rate of complication and the braking time after the puncture in the two groups. Results The incidence rate of complication in the control group was significant higher than that of in the observation group, P

A study about posture changing to ameliorate dysuria for patients with femoral artery puncture and catheterization / 中国实用护理杂志

ObjectiveTo explore whether the posture changing can ameliorate the dysuria for patients with femoral artery puncture and catheterization, and observe the influence of posture changing on blooding in the point of puncture. Methods Changing patients′ posture under the order of nurses, and then observed the amelioration condition of dysuria. Results After using intervention method, the rate of urinary stasis decreased from 31.67% to 4.17%, the rate of using urethral catheterization also decreased from 8.33% to 1.67%. Conclusion Posture changing was an effective method to ameliorate the dysuria for patients with femoral artery puncture and catheterization.