Access site complications

Technologic advances in the design of catheters and devices have allowed a more aggressive approach to percutaneous coronary intervention (PCI), which has resulted in an increase in the volume and complexity of procedures. This chapter describes the incidence, predisposing factors, and treatment options for some of the most common non-cardiac complications following PCI. Access site bleeding is the most frequent complication following femoral arterial access. Vascular access dissection contributes to the development of distal extremity ischemia, pseudoaneurysm, or thrombus formation. The diagnosis of retroperitoneal bleeding are confirmed by computed tomography (CT) or abdominal/pelvic ultrasound. Local infection at the site of arterial access occurs in less than 1% of patients following coronary interventional procedures. Transradial access for interventional coronary catheterization is being performed with increasing frequency because hemostasis can be obtained easily by local compression of the superficial course of the radial artery.