Chapter 50 - Endovascular complication

Question 1

Rate of access complication and surgical repair

Answer 1

historically 6.1% complication, 2.3% require repair, 1.8% need transfusion

now hematoma 3%, stenosis/occlusion 0.2%

Question 2

Risk factors for access site complicadtions

Answer 2

1) older age
2) warfarin
3) CHF
4) no U/S
5) large sheath
6) intervention done
7) emergency
8) COPD
9) antiplatelet
10) HTN
11) tibial intervention

Question 3

Rate of AVF after groin puncture

Answer 3

0.5-0.86%

Question 4

Rate of PSA after groin puncture

Answer 4

< 1%

Question 5

Treatment of PSA groin access

Answer 5

1) U/S guided thrombin
2) surgical repair
3) U/S compression - 74-93%

Question 6

Reasons to treat PSA with open surgery

Answer 6

1) larger PSA
2) wide neck
3) failed compression or thrombin

Question 7

Rate of access vessel thrombosis

Answer 7

0.2%

Question 8

Rate of brachial access complication

Answer 8

9%

7. 2% hematoma
8. 1% stenosis/occlusion
9. 4-12.7% nerve injury

worse than femoral

Question 9

Rate of axillary artery access complication

Answer 9

2.3%

Question 10

Radial artery access complication - occlusion and pseudoaneurysm

Answer 10

7. 7% occlusion - reduces to 5.5% at 1 week

0. 08% pseudoaneurysm

Question 11

Factors involved in failure of pre-close for EVAR

Answer 11

1) obesity
2) thoracic aneurysm
3) CFA calcification
4) CFA depth > 4cm
5) sheath size > 20Fr

Question 12

Treatment of iatrogenic dissection

Answer 12

1) balloon tacking

2) stenting if > 30% narrowed lumen

Question 13

treatment of embolization

Answer 13

1) anticoagulation prevention
2) local infusion of TPA
3) aspiration catheter
4) open repair

Question 14

Rate of perforation in angioplasty infrainguinal

Answer 14

3.7%

Question 15

Rate of atherectomy perforation

Answer 15

< 1%

Question 16

Rate of iliac injury in TEVAR and EVAR

rate of open surgery and mortality

Answer 16

TEVAR 8.9%
EVAR 2.98%

open 25%
mortality 20%

Question 17

Two major trials comparing surgery and thrombolysis

Answer 17

Thrombolysis and peripheral arterial surgery TOPAS

Surgery vs thrombolysis for ischemia of the lower extremity STILE

Question 18

Rate of life-threatening hemorrhage after thrombolysis

Answer 18

5.6-13%

Question 19

Intracranial hemorrhage after TPA

Answer 19

0.7%

Question 20

GI hemorrhage after TPA

Answer 20

1.6%

Question 21

Fibrinogen level that warrants investigation after TPA

Answer 21

< 150 mg/dl

Question 22

Rate of infection after EVAR/TEVAR

Answer 22

0.6-0.77%

Question 23

Most common organism for stent infection

Answer 23

Staph aureus