Abstract 381: Femoral Artery Access Safety and Outcomes Across Multiple Specialties on a Novel Interventional Platform
Background: The Rush University Medical Center interventional platform is a novel hospital design concept created to facilitate multidisciplinary collaboration and centralize common resources in effort to improve safety and outcomes. Currently, there are no outcomes studies that evaluate the utility of an interventional platform. Multiple specialties on our platform utilize femoral artery access in a heterogeneous fashion. While complications are uncommon, they may affect morbidity, mortality, cost and length of hospital stay. We instituted a standardized femoral artery access workflow across the subspecialties on our interventional platform to evaluate techniques and outcomes.
Methods: A prospective cohort of patients undergoing femoral artery access procedures on our interventional platform performed by interventional cardiology, electrophysiology, interventional radiology, and neurointerventional services was studied. Arterial access and hemostasis technique as well as periprocedural medications were at the operators’ discretion. Patients were evaluated for complications, including bleeding, thrombosis, pseudoaneurysm, and arteriovenous fistula formation.
Results: Data was collected on 696 consecutive patients undergoing femoral artery access. Across subspecialties, there were significant differences in imaging modalities and adjunct tools used to obtain arterial access, frequency and types of closure device used, and intraprocedural medications. Notably, the neurointerventional service utilized adjunct modalities to achieve femoral artery access in significantly less cases compared to other specialties (16.8% vs. 65.7%; P<0.0002). Complications occurred in 5 procedures (0.72%), including 2 (0.45%) closure device and 3 (1.6%) manual compression cases; of the complications, 4 (2.1%) were neurointerventional procedures and 1 (0.29%) was a cardiology procedure.
Conclusions: Institution of a standardized femoral artery access workflow on an interventional platform facilitated accurate monitoring of femoral artery access procedural techniques and complications across multiple specialties. Overall complication rates were similar to historical studies; however, varying practice patterns between subspecialties may have contributed to differing complication rates. Additional standardization of femoral artery access and hemostasis techniques across an interventional platform may further improve outcomes.
Author Disclosures: M.J. Shih: None. R. Olstein: None. K. Keigher: None. S. Capalbo: None. J. Snell: None.
- © 2014 by American Heart Association, Inc.