Preditores e incidência de complicações vasculares após a realização de intervenções coronárias percutâneas: achados do Registro IC-FUC

Abstract

Background: Vascular complications (VC) following percutaneous coronary intervention (PCI) are an important cause of morbidity and mortality. However, available data do not reflect current interventional cardiology practice. Objective: To determinate the incidence of VC and its predictors in a population treated with PCI in contemporary practice. Methods: Cross-sectional study with coronary stent implantation conducted from January/2000 to December/2007. Clinical and angiographic characteristics, as well as in-hospital evolution, were evaluated and recorded in a database. Exclusion criteria included in-hospital death and urgent heart surgery. VC were defined as major bleeding, vascular surgery or hematoma > 10 cm. Data were analyzed using SPSS 11.0 and the characteristics of patients with and without VC were compared using the Student's t test and chi-square test. Multiple Logistic Regression Analysis was performed to determinate the independent predictors of VC. Results: A total of 4,595 patients with 5,485 stents were included in this analysis. Mean age was 60.64 ± 10.65 years and 32% of the patients were female. The transfemoral approach was used in 95% of the PCIs and the transradial approach in 5%. Six French and 7 French introducers were used in 85% and 15% of the PCIs, respectively. A total of 162 (3.3%) patients experienced VC. The multivariate analysis determined that the only predictor for VC was the use of 7 French introducers (odds ratio = 3.05, 95% confidence interval = 1.2-7.8; p = 0.02).

Vascular complications in patients who underwent endovascular cardiac procedures: multicenter cohort study

“…Some studies do not address minor complications, so that, if we verify the incidence of major complications only, here defined as hematoma ≥10cm, unstable bleeding, retroperitoneal hematoma, pseudoaneurysm, and arteriovenous fistula, the rate remains at 1.6%, including diagnostic and therapeutic procedures. A rate of 1.6% is relatively low, when compared to results previously reported that considered only major complications, at approximately 3% 1 , 17 . …”

Complicações vasculares em pacientes submetidos a intervenção coronária percutânea precoce por via femoral após fibrinólise com tenecteplase: registro de 199 pacientes

“…The present study evaluated patients undergoing early drug-invasive strategy through femoral access, and a low incidence of hemorrhagic vascular complications was observed (3%), similar to that observed in elective interventions, 21 demonstrating the safety of this approach. In their analysis of 4,595 patients under going PCI, either elective or emergency, in which 95% of the procedures were performed via the femoral artery with 6-F sheaths, Zanatta et al 21 observed a vascular complication rate of 3.3%.…”

Complicações da intervenção coronária percutânea: inferência dos diagnósticos de enfermagem

“…Um grande inquérito avaliando um banco de dados informatizado no total de 4.595 pacientes com 5.485 stents implantados, com média de idade de 60,64 ± 10,65 anos e 32% de mulheres, as ICP foram realizadas pela via femoral em 95% dos casos e pela via radial em 5%, e em 85% dos procedimentos foram utilizados introdutores 6F (em 15% foram usados introdutores 7F). Foram registradas complicações vasculares em 162 (3,3%) pacientes, sendo o único preditor o uso de introdutores 7F (OR=3,05, IC95%=1,2-7,8; p=0,02) [3].…”

“…Trata-se de um exame invasivo para confirmar a presença de obstruções das artérias coronarianas ou avaliar o funcionamento das válvulas e do músculo cardíaco. Estudos comprovam que os principais preditores de complicação vascular para o procedimento são: sexo feminino, idade superior a 70 anos, diabetes, hipertensão e tabagismo [3][4][5]. Com o avanço da tecnologia, a angioplastia coronariana (AC) é o método mais utilizado para intervenção coronariana percutânea, tendo em vista a rápida recuperação do paciente [3].…”