Abstract
When addressing endovascular procedures, complication avoidance is often aimed at the critical portions of a procedure where the risk for a catastrophic outcome is the highest, for example, when deploying a framing coil in a ruptured aneurysm or delivering a liquid embolic to a potential area of eloquent cortex adjacent to an AVM. A perfectly framed aneurysm can be a satisfying result for both the interventionalist and the patient, but this success is easily belittled when access site complications occur at the beginning or end of an endovascular procedure. Formidable complications, such as the loss of a limb, or even the need for unplanned rescue procedures or surgeries required to treat the complications, are avoidable with prudent preparation from the interventionalist. This chapter will address complication avoidance in arteriotomy site access and closure, as well as management when these unfortunate outcomes manifest.
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References
Lee DH, et al. Routine transradial access for conventional cerebral angiography: a single operator's experience of its feasibility and safety. Br J Radiol. 2004;77(922):831–8.
Levy EI, et al. Transradial cerebral angiography: an alternative route. Neurosurgery. 2002;51(2):335–40. Discussion 340–2.
Nohara AM, Kallmes DF. Transradial cerebral angiography: technique and outcomes. AJNR Am J Neuroradiol. 2003;24(6):1247–50.
Amin FR, et al. Femoral haemostasis after transcatheter therapeutic intervention: a prospective randomised study of the angio-seal device vs. the femostop device. Int J Cardiol. 2000;76(2–3):235–40.
Biancari F, et al. Meta-analysis of randomized trials on the efficacy of vascular closure devices after diagnostic angiography and angioplasty. Am Heart J. 2010;159(4):518–31.
Cremonesi A, et al. Femoral arterial hemostasis using the angio-seal feminine system after coronary and vascular percutaneous angioplasty and stenting. J Invasive Cardiol. 1998;10(8):464–9.
Das R, et al. Arterial closure devices versus manual compression for femoral haemostasis in interventional radiological procedures: a systematic review and meta-analysis. Cardiovasc Intervent Radiol. 2011;34(4):723–38.
Kapadia SR, et al. The 6Fr Angio-Seal arterial closure device: results from a multimember prospective registry. Am J Cardiol. 2001;87(6):789–91, A8.
Kussmaul WG III, et al. Rapid arterial hemostasis and decreased access site complications after cardiac catheterization and angioplasty: results of a randomized trial of a novel hemostatic device. J Am Coll Cardiol. 1995;25(7):1685–92.
Nikolsky E, et al. Vascular complications associated with arteriotomy closure devices in patients undergoing percutaneous coronary procedures: a meta-analysis. J Am Coll Cardiol. 2004;44(6):1200–9.
Pollard SD, et al. Position and Mobilisation Post-Angiography Study (PAMPAS): a comparison of 4.5 hours and 2.5 hours bed rest. Heart. 2003;89(4):447–8.
Schickel SI, et al. Achieving femoral artery hemostasis after cardiac catheterization: a comparison of methods. Am J Crit Care. 1999;8(6):406–9.
Wu PJ, et al. Access site complications following transfemoral coronary procedures: comparison between traditional compression and angioseal vascular closure devices for haemostasis. BMC Cardiovasc Disord. 2015;15:34.
Cox N, Resnic FS, Popma JJ, et al. Managing the femoral artery in coronary angiography. Heart Lung Circ. 2008;17(Suppl.4):S65–9.
Deshaies EM, Eddleman CS, et al. Handbook of neuroendovascular surgery: Chapter 10. Endovascular complications.
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Thabet, A.M., Singh, I.P. (2018). Access and Closure. In: Gandhi, C., Prestigiacomo, C. (eds) Cerebrovascular and Endovascular Neurosurgery. Springer, Cham. https://doi.org/10.1007/978-3-319-65206-1_21
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DOI: https://doi.org/10.1007/978-3-319-65206-1_21
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