Access‑site complications after peripheral vascular interventions in patients with peripheral arterial disease at Assiut University Hospital

Aim: The aim was to describe the incidence of access-site complications (ASCs) and determine the risk factors leading to them in patients undergoing endovascular interventions for treatment of peripheral arterial disease. Materials and methods: A prospective study was conducted on all patients who underwent endovascular procedures for the treatment of peripheral arterial disease at the Department Vascular Surgery, Assiut University Hospital, between May 2017 and May 2018. Access choice depended on the vessel condition, Duplex ultrasound examination, and surgeon’s preference. ASCs were detected using clinical and duplex ultrasound examination. Follow-up of patients was done at 3 and 6 months postoperatively. Univariate and multivariate analyses were used to determine risk factors predicting occurrence of ASCs. Results: Of the 210 patients, ASCs were encountered in 23 (11%) cases. Nine (4.3%) patients presented with thrombosis of the access artery, eight (3.8%) had access-site hematoma, four (1.9%) complained of external bleeding, and two patients (0.95%) presented with femoral artery pseudoaneurysm. Significant risk factors for ASCs were advanced age (P=0.027), hypertension (P=0.011), increased BMI (P=0.015), small vessel diameter (P=0.031), and prolonged procedure time (P 0.0001). BMI and procedure time were found to be predictors of occurrence of ASCs. Conclusion: Long procedure time and increased BMI were found to be predictive of the occurrence of ASCs. Early detection and management of ASCs provide good outcome after 6-month follow-up.