Hemodynamics in Daily Practice

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Create Alert. Share This Paper. Figures, Tables, and Topics from this paper. Figures and Tables. Citations Publications citing this paper. Osterhues , Vinzenz Hombach , Arthur J. Nienaber , Rossella Fattori. References Publications referenced by this paper. Circulation 80 Supp!. II : II Abstract. ML Simoons , A Arnold. Plasminogen Activator Italian Multicenter Study PAIMS : comparison of intravenous recombinant single-chain human tissue-type plasminogen activator rt-PA with intravenous streptokinase in acute myocardial infarction.

Bruno Magnani. The hibernating myocardium. This complication is often asymptomatic and there is a trend toward reduction in occlusion rates in evaluations carried out during longer periods of post-procedure follow-up.

Hemodynamics in Daily Practice

Retroperitoneal hematoma, due to its direct association with femoral puncture, is not a complication evaluated in procedures using another access route. Although rare, when it occurs it usually requires blood transfusion, and surgical procedure in some cases. An American study that evaluated factors associated with the development of this complication showed that most cases of retroperitoneal hematoma occurred in the first hours after the procedure.


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Other complications, such as artery laceration 4 , artery perforation 41 , granuloma 42 , mycotic aneurysm, arterial dissection, compartment syndrome, and limb ischemia 43 were reported in the selected publications, but due to their rare presentation they were only mentioned in the definitions of the complications evaluated or were reported in review studies as rare occurrences.

Female gender 44 - 45 and age older than 75years 4 , 44 were identified as the main predictors of complications. Regarding evaluation of the complications, this is initially clinical, through signs and symptoms, and may require imaging examinations 46 for diagnosis confirmation. When more serious, they may require surgical treatment or blood transfusion. The knowledge of teams on the recognition and clinical management of complications, especially in units that admit patients from hemodynamic laboratories, helps to promote continuity of care, with interventions to minimize or prevent these complications so that better results may be achieved.

Different factors are associated with the results of patients, such as factors inherent to the each patient, therapy, and questions regarding to the procedure and team. Among predictors of vascular complications, female gender and advanced age are those more often identified, and healthcare teams must also consider these aspects in post-procedure care. There is a trend toward better results with the use of vascular closure devices compared with other hemostatic methods but, when complications occur, they must be carefully monitored.

Early mobilization proved to be a safe practice after PCI when compared with longer standard periods of rest. Programs for hospital discharge on the same day after PCI may be feasible for carefully selected patients. The use of a specific technique by interventionists as a standard puncture may influence the results if another puncture technique is adopted. Lower time of hemostatic compression and hemostasis in radial puncture were associated with lower incidence of radial artery occlusion.

The radial approach must be prioritized whenever possible, because it enables better results regarding bleeding and vascular access complications. The radial approach is recommended as the first choice in acute coronary syndrome and primary PCI, when carried out by experienced radial hemodynamicists. Vascular access complications from procedures may be conservatively managed with non-invasive therapies, percutaneous or endovascular treatment; when more serious, surgical procedure may be required.

The delimitation of the search period to 10 years may have failed to consider articles, theses, or dissertations that would contribute to add results to the research questions. Analysis of the publications by two evaluators occurred only in the selection stage, by title and abstract, and was not possible in the full reading of the articles.

In the categorization regarding the type of study, the description found in the article was considered, and not the impression of the evaluator after full content analysis. The total number of publications included in the scoping review shows that the theme has been widely studied. In the context of percutaneous procedures, the femoral access route was identified as the most used approach in hemodynamic laboratory procedures. The most highlighted complications associated with the access site in post-procedures were ecchymosis, arteriovenous fistula, hematoma, retroperitoneal hematoma, puncture infection, arterial occlusion, pseudo-aneurysm, and bleeding.

These complications ranged according to the access route used.


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  7. Vascular access complication diagnoses are based on findings in history and physical examinations, and they may usually be confirmed through imaging. The methodological path taken may be useful for the teaching and development of new studies, because scoping reviews are still an incipient methodology in the nursing knowledge area. This type of review, although its method does not anticipate the exclusion of articles according to methodological quality criteria, enables researchers to specify the type of literature that will not be included in its protocol. In clinical practice, this study contributes to the body of knowledge on percutaneous procedure complications, providing substitutes for actions in patient care.

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    Repeatability of Fractional Flow Reserve Despite Variations in Systemic and Coronary Hemodynamics.

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    Prospective comparison of angio-seal versus manual compression for hemostasis after neurointerventional procedures under systemic heparinization. J Am Coll Cardiol. Standardizes radial approach reduces access site complications: a prospective observational registry.

    Coron Artery Dis. Rev Bras Cardiol Invas. Safety and feasibility of transulnar versus transradial artery approach for coronary catheterization in non-selective patients. Chin Med J Engl. Evaluation of a structured training program for arterial femoral sheath removal after percutaneous arterial catheter procedures by assistant personnel. Increased vascular access complications in patients with renal dysfunction undergoing percutaneous coronary procedures using arteriotomy closure devices. Influence of use of a vascular closure device on incidence and surgical management of access site complications after percutaneous interventions.

    Eur J Vasc Endovasc Surg. Acesso radial vs. Rev Bras Cardiol Invas iva. Radial versus femoral access for coronary angiography and intervention in patients with acute coronary syndromes RIVAL : a randomised, parallel group, multicentre trial.

    Cardiovascular Hemodynamics for the Clinician - ywodypodadyc.tk

    Access site management after peripheral percutaneous transluminal procedures: Neptune pad compared with conventional manual compression. A comparison of transradial and transfemoral approaches for percutaneous coronary intervention in elderly patients based on a propensity score analysis.

    Unusual vascular complications associated with a transradial coronary procedures among 10, patients: case based experience and treatment options. J Interv Cardiol. Identification and management of complications of transradial procedures.

    senjouin-renkai.com/wp-content/bluetooth/apple-iphone-6-ortung-ausschalten.php Curr Cardiol Rep. Management and timing of access-site vascular complications occurring after trans-radial percutaneous coronary procedures. Int J Cardiol. Cost-effectiveness of contemporary vascular closure devices for the prevention of vascular complications after percutaneous coronary interventions in an all-comers PCI population.

    Femoral vascular access-site complications in the cardiac catheterization laboratory: diagnosis and management. Interv Cardiol. Corresponding author: Miriam de Abreu Almeida. This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Services on Demand Journal. Integrative Review Vascular access complications in patients undergoing percutaneous procedures in hemodynamics: a scoping review. RESULTS One-hundred twenty-eight publications that made it possible to map the contexts of study of complications, occurrence according to access routes, as well as an understanding of diagnosis and clinical management, were included.

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