Local infection after percutaneous transluminal coronary angioplasty: Relation to early repuncture of ipsilateral femoral artery

Abstract

We describe two cases of groin infection following repuncture of the femoral artery to perform coronary angioplasty soon after diagnostic coronary arteriography. This serious complication can be avoided by using the contralateral femoral artery in this setting, even if the previously used entry site appears benign.

Nonvalvular Cardiovascular Device–Related Infections

“…143,144 Repeat puncture of the ipsilateral femoral artery and leaving indwelling femoral artery sheaths for several days after the procedure have been associated with an increased incidence of infec-tion. 145 Indwelling sheaths are usually connected to a pressurized heparin solution, which also increases the risk of local infection and/or bacteremia. 144 In one study, older age and recent congestive heart failure were independent predictors of postprocedural bacteremia.…”

Septic endarteritis following percutaneous transluminal coronary angioplasty

“…In order to avoid local infections, some authors recommend that the contralateral groin site be used for PTCA following recent catheterization [3,11,12]. If the lefthanded contralateral approach is unacceptable for technical reasons, prophylactic antibiotics should be administered around the time of ipsilateral catheterization, even though the authors stress that the benefit of this approach remains to be established.…”

Ruptured Splenic Abscess following Percutaneous Transluminal Angioplasty in a 40-Year-Old Man

“…Standard aseptic techniques may be inadequate if early repuncture is performed or if an indwelling line is utilized. Prophylactic antibiotics should be considered in these cases, although their usefulness has not been formally demonstrated so far [10]. The following risk factors may predispose a patient to infectious sequelae following PTCA: early reuse of the initial puncture site, prolonged retention of the femoral sheath, bleeding or hematoma at the femoral sheath insertion site and vascular complications such as pseudoaneurysms [11].…”