Abstract TP461: Predictors of Groin Punction Complication After Edovascular Therapies

Abstract

Background: Endovascular therapies(EVT) have exponentially increased in the last few years. To maximize the benefits of EVT, complications related to the treatment need to be prevented or minimized with early detection and appropriate management. We implemented a specific registry to collect femoral post-puncture complications detected at different timepoints. Our aim was to identify factors associated with severe groin punction complications. Methods: Prospective study of consecutive patients treated with acute EVT or scheduled (angioplasty), admitted to our Stroke Unit from February2017-June2018. Post-catheterization femoral complications included: groin bleeding(GB), groin hematoma(GH), retroperitoneal hematoma(RH), femoral artery pseudoaneurysm(FAP), and artery dissection(AD). A specific registry was created for data collection at different timepoints: During or immediate post-EVT, at 24h post-compression and at discharge. Results: 384patients were treated with EVT(73%acute), mean age 71+/-13y.o, 69% men. Mynxgrip closure system was used in 346(91,8%). Compressive measures needed to be reinforced in 55 cases(14,5%)/changed in 15(4%). Early mobilization protocol(24-48h) was initiated in 335patients(92,3%). 9patients (2,8%) did not maintain the first 24h absolute rest. 57patients(15,1%) presented mild immediate complications(49GH,6GB). At 24h, 181(47,1%)patients presented GH(28,6%superficial, 18,2%internal) and 5GB(1,3%). At discharge, 29(8,1%)patients had presented clinically significant femoral complications: 16GH(13deep), 5FAP, 1AD, 4RH. 2 of those complications were fatal. Variables associated with severe complications at discharge were: age(p=0.037), non-use of mynxgrip(p=0.001), compressive replacement(p<0.001), non-compliance of early mobilization protocol(p=0.014). Conclusion: In our series, we found a yield of 8,1% of clinically significant groin complications associated with the EVT (0,5% fatal). We indentified age, closure device, requirement to replace compressive and lack of accomplishment of the early mobilization protocol as predictors of these complications.