Complication rates for percutaneous lower extremity arterial antegrade access

Brian J. Wheatley, M. Ashraf Mansour, P. Michael Grossman, Khan Munir, Robert F. Cali, Jill M. Gorsuch, Robert F. Cuff, Peter Y. Wong, Christopher M. Chambers

Research output: Contribution to journalArticlepeer-review


Hypothesis: The antegrade access (AA) for percutaneous arterial interventions is associated with a higher complication rate than is the retrograde access (RA). Design: Retrospective case review. Setting: A statewide consortium for peripheral vascular interventions consisting of 13 Michigan hospitals collecting data on their endovascular procedures. Patients: Demographic and procedure data on all patients receiving a percutaneous peripheral arterial intervention were entered prospectively by a full-time clinical nurse specialist in each hospital site. Main Outcome Measures: We evaluated vascular complications as a composite of retroperitoneal hematoma, pseudoaneurysm, hematoma requiring blood transfusion, arteriovenous fistula, acute thrombosis, or the need for surgical repair of the access site. Results: In a 2-year period, we collected 6343 cases, of which 5918 had complete data regarding arterial access; of these, 745 (12.6%) were performed via an AA. There were fewer women and smokers (P<.001) in the AA group but more diabetic patients (P<.001). The indications for intervention were more frequently rest pain (P<.001) and limb salvage (P<.001) in the AA group. Multivariate regression analysis showed that the odds of complications were significantly higher with a larger sheath (95% confidence interval, 1.53-4.06; P<.001). Also, the incidence of blood transfusion and subsequent amputation was significantly higher in theAAgroup (P<.001). Conclusion: Endovascular procedures performed via an AA are more likely to result in perioperative complications and therefore should be used cautiously.

Original languageEnglish (US)
Pages (from-to)432-435
Number of pages4
JournalArchives of Surgery
Issue number4
StatePublished - Apr 2011
Externally publishedYes

ASJC Scopus subject areas

  • Surgery


Dive into the research topics of 'Complication rates for percutaneous lower extremity arterial antegrade access'. Together they form a unique fingerprint.

Cite this