Table 1.
Baseline characteristics for all patients with major vascular complications.
Table 2.
Vascular complications and procedural characteristics.
Fig 1.
A 66-year-old female experienced a high retrograde puncture above the inguinal ligament, 2.5 cm cranial to the femoral head.
Despite manual compression, a rapidly increasing groin haematoma developed. (a) Angiography demonstrated active extravasation from the iliac external artery, immediately above the level of the inguinal ligament. (b) Contrast-enhanced computed tomography scans demonstrated active extravasation from the external iliac artery and an accompanying haematoma. (c) Successful sealing of the perforation was achieved by deployment of an 8 x 26 mm covered stent (LIFESTREAM; C. R. Bard, USA) via a contralateral crossover approach.
Fig 2.
(a) Iatrogenic pseudoaneurysm after failed manual compression. (b) After placing an angioplasty balloon (6 mm in diameter) from a contralateral femoral approach and inflation, thrombin injection was performed under ultrasound guidance. (c) Angiography showing successful thrombosis of the pseudoaneurysm after percutaneous thrombin injection.
Fig 3.
A 79-year-old male with a pulsatile mass at the puncture site and pain following percutaneous coronary intervention via femoral access.
(a) Angiography using a contralateral femoral approach revealed a pseudoaneurysm. (b) A 7 x 16 mm, balloon-expanding, covered stent (LIFESTREAM; C. R. Bard, USA) was deployed. Angiography demonstrated successful sealing of the pseudoaneurysm.
Fig 4.
A 70-year-old woman developed acute ischemia of the right leg after percutaneous coronary intervention.
(a) Total occlusion of the common femoral artery was revealed with angiography using a contralateral femoral approach. (b, c) Prolonged inflation of an angioplasty balloon was performed. (d) After completion, angiography revealed revascularization of the common femoral artery with a non-flow-limiting intimal dissection. The superficial and deep femoral arteries demonstrated patency, and stenting was not necessary.
Table 3.
Basic bail-out set for treating iliofemoral access site complications.