Chapter 27
Vascular Access Site Complications
Miguel Alvarez Villela,
Cristina Sanina,
Robert Pyo,
Miguel Alvarez Villela
Search for more papers by this authorCristina Sanina
Search for more papers by this authorRobert Pyo
Search for more papers by this authorMiguel Alvarez Villela,
Cristina Sanina,
Robert Pyo,
Miguel Alvarez Villela
Search for more papers by this authorCristina Sanina
Search for more papers by this authorRobert Pyo
Search for more papers by this authorBook Editor(s):George D. Dangas MD, MACC, MSCAI, FAHA, FESC,
Carlo Di Mario MD, PhD, FRCP, FACC, FSCAI, FESC,
Holger Thiele MD,
Peter Barlis MBBS, MPH, PHD, FACC, FESC, FRACP,
Tayo Addo MD, Bimmer Claessen MD, Christian Hengstenberg MD, Nicholas Kipshidze MD,
George D. Dangas MD, MACC, MSCAI, FAHA, FESC
Professor of Medicine (Cardiology) & Surgery (Vascular) Professor of Cardiology Adjunct Professor of Internal Medicine
Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, New York, NY, USA
National Kapodistrian University of Athens, Greece
Medical University of Vienna, Austria
Search for more papers by this authorCarlo Di Mario MD, PhD, FRCP, FACC, FSCAI, FESC
Professor of Cardiology Director of the Structural Interventional Cardiology Division Honorary Consultant
University of Florence
University Hospital Careggi, Florence, Italy
Cardiologist Royal Brompton Hospital, London, UK
Search for more papers by this authorHolger Thiele MD
Professor of Cardiology at University of Leipzig
Heart Center Leipzig at University of Leipzig, Leipzig, Germany
Search for more papers by this authorPeter Barlis MBBS, MPH, PHD, FACC, FESC, FRACP
Professor of Cardiology Interventional Cardiologist
University of Melbourne, Melbourne, Victoria, Australia
St Vincent's & Northern Hospitals Victoria, Australia
Search for more papers by this authorFirst published: 06 May 2022
Summary
Vascular complications are relatively common after endovascular procedures, such as PCI or peripheral vascular interventions. The advent of higher complexity procedures, including percutaneous mechanical circulatory support, demands familiarity of the interventional cardiologist with these complications and their treatment options.
The prevention of vascular complications starts with a good vascular access technique. We review the evidence behind different techniques to ensure optimal access. When complications arise, many can be managed with noninvasive measures. However, complications that result in acute vessel obstruction or persistent bleeding may require prompt intervention. Here, we describe a variety of percutaneous management options. However, treatment strategies should always be defined in conjunction with the vascular surgery team to avoid unnecessary heroic percutaneous attempts in lieu of more feasible surgical options.
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