Predictors Of Periprocedural Complications Research Articles

Predictors of Periprocedural Complications in Patients with Myocardial Infarction Undergoing Coronary Interventions

Predictors of Periprocedural Complications in Patients with Myocardial Infarction Undergoing Coronary Interventions

IMPACT OF FRAILTY ON OUTCOMES IN PATIENTS UNDERGOING TRANSCATHETER AORTIC VALVE REPLACEMENT: A REPORT FROM NATIONAL INPATIENT SAMPLE

Frailty is a known predictor of periprocedural complications and recovery after cardiovascular interventions. Its impact on in-hospital outcomes in patients undergoing TAVR is not well studied. We conducted a study using National Inpatient Sample (NIS) database to assess the effect of frailty on in-

Predictors of Periprocedural Complications and Angiographic Outcomes of Endovascular Therapy for Large and Giant Intracranial Posterior Circulation Aneurysms

To explore the predictors of periprocedural complications and angiographic outcomes in large and giant intracranial posterior circulation aneurysms after endovascular treatment. Data from 99 patients with 103 large (≥10 mm; n= 94) and giant (>25 mm; n= 9) posterior circulation aneurysms treated with endovascular therapy at a single center were retrospectively analyzed. The treatment procedures included endovascular trapping (n= 15), coiling (n= 6), stent only (n= 10), stent-assisted coiling (n= 48), and pipeline embolization device (PED; n= 24). The outcome endpoints were the number of periprocedural complications and number of complete occlusions without any complication. Multivariate analysis revealed that intradural vertebral aneurysms (P= 0.041) and aneurysms ≤25 mm (P= 0.042) were associated with low periprocedural complication rates after endovascular therapy. Aneurysms not involving side branches (P= 0.024) and intradural vertebral aneurysms (P= 0.032) were predictors of complete aneurysm obliteration. No statistically significant differences were found in aneurysmal complete obliteration (P= 0.119) or periprocedural complications (P=0.248) between a PED and traditional stent and coiling. Additionally, aneurysms not involving side branches (P= 0.030), intradural vertebral artery aneurysms (P= 0.003), and aneurysms treated with a PED (P= 0.020) were more likely to achieve complete occlusion over time. Aneurysm location, aneurysm size, and side branch involvement were predictors of periprocedural complications and angiographic outcomes of endovascular therapy for large and giant intracranial posterior circulation aneurysms. PED use provided no advantages compared with traditional stent and coiling in aneurysmal occlusion rates and periprocedural complications. Large case-control and long-term follow-up studies are needed to further explore the predictors of complications and angiographic outcomes and optimal treatment options for these aneurysms.

Prevalence and Predictors of Complications of Radiofrequency Catheter Ablation for Atrial Fibrillation

Up to 6% of patients experience complications after radiofrequency catheter ablation (RFA) of atrial fibrillation (AF). The purpose of this study is to determine the prevalence and predictors of periprocedural complications after RFA for AF. The subjects were 1,295 consecutive patients (age = 60 ± 10 years) who underwent RFA (n = 1,642) for paroxysmal (53%) or persistent AF (47%) from January 2007 to January 2010. A complication occurred in 57 patients (3.5%); a vascular access complication in 31 (1.9%); pericardial tamponade in 20 (1.2%); a thromboembolic event in 4 (0.2%); deep venous thrombosis in 1 (<0.01%); and pulmonary vein stenosis in 1 patient (<0.01%). There were no procedure-related deaths. On multivariate analysis, female gender (OR = 2.27; ±95% CI: 1.31-2.57, P < 0.01) and procedures performed in July or August (OR = 2.10; ±95% CI: 1.16-3.80, P = 0.01) were independent predictors of any complication. For vascular complications, treatment with clopidogrel (OR = 4.40; ±95% CI: 1.43-13.53, P = 0.01), female gender (OR = 3.65; ±95% CI: 1.72-7.75, P < 0.01) and performing RFA in July or August (OR = 2.71; ±95% CI: 1.25-5.87, P = 0.01) were independent predictors. The only predictor of cardiac tamponade was prior RFA (OR = 3.32; ±95% CI: 0.95-11.61; P < 0.05). Prevalence of perioperative complications for RFA of AF is 3.5% and vascular access complications constitute the majority. The need for clopidogrel therapy should be carefully considered prior to RFA. At teaching institutions close supervision should be exercised during vascular access early in the year. Improvements in ablation technology and elimination of the need for repeat procedures may decrease the risk of pericardial tamponade.