Vascular Closure Devices Reduce Complications From PCI
Benefit not seen in patients with normal or lean BMI or those on platelet glycoprotein inhibitors
THURSDAY, Nov. 21, 2013 (HealthDay News) -- Vascular closure devices (VCDs) are associated with a significant reduction in vascular complications and need for transfusion in patients having transfemoral percutaneous coronary intervention (PCI), according to a study published in the Nov. 19 issue of the Annals of Internal Medicine.
Hitinder S. Gurm, M.D., from the University of Michigan in Ann Arbor, and colleagues analyzed outcomes in consecutive patients having emergent and non-emergent PCI from 2007 to 2009, treated in 32 Michigan hospitals participating in a large multicenter quality improvement collaborative.
The researchers found that, of the 85,048 PCIs performed during the study, 37 percent of procedures used VCDs. VCDs were associated with reductions in vascular complications (odds ratio [OR], 0.78; P = 0.001) and post-procedure transfusions (OR, 0.85; P = 0.011) in propensity-matched analysis. Except for patients with a body mass index (BMI) less than 25 kg/m² and those treated with platelet glycoprotein (GP) IIb/IIIa inhibitors, the findings were consistent. More specifically, VCDs were associated with fewer hematomas (OR, 0.69; P < 0.001) or pseudoaneurysms (OR, 0.54; P < 0.001) and an increase in the odds of retroperitoneal bleeding (OR, 1.57; P = 0.009).
"VCDs were associated with a significant reduction in vascular complications and need for transfusion in this large cohort of patients having transfemoral PCI," the authors write.
Blue Cross Blue Shield of Michigan partially funded the study.