Marc-André d'Entremont; Sulaiman Alrashidi; Omar Alansari; Bradley Brochu; Laura Heenan; Elizabeth Skuriat; Jessica Tyrwhitt; Micheal Raco; Micheal Tsang; Nicholas Valettas; James Velianou; Tej Sheth; Matthew Sibbald; Shamir  R. Mehta; Natalia Pinilla-Echeverri; John-David Schwalm; Madhu  K. Natarajan; Andrew Kelly; Elie Akl; Sarah Tawadros; Mercedes Camargo; Walaa Faidi; John Bauer; Rachel Moxham; James Nkurunziza; Gustavo Dutra; Jose Winter; Sanjit Jolly

doi:10.4244/EIJ-D-22-01130

The Official Journal of EuroPCR and the European Association of Percutaneous Cardiovascular Interventions (EAPCI)

Clinical research

DOI: 10.4244/EIJ-D-22-01130

Ultrasound-guided femoral access in patients with vascular closure devices: a prespecified analysis of the randomised UNIVERSAL trial

Marc-André d'Entremont¹^,², MD, MPH; Sulaiman Alrashidi³^,⁴^,⁵, MD; Omar Alansari³^,⁴^,⁵, MD; Bradley Brochu⁶, MD; Laura Heenan², MSc; Elizabeth Skuriat², MSc; Jessica Tyrwhitt², BSc; Micheal Raco³^,⁴^,⁵, MD; Micheal Tsang³^,⁴^,⁵, MD, MSc; Nicholas Valettas³^,⁴^,⁵, MD, MASc; James L. Velianou³^,⁴^,⁵, MD; Tej N. Sheth²^,³^,⁴^,⁵, MD; Matthew Sibbald³^,⁴^,⁵, MD, PhD; Shamir R. Mehta²^,³^,⁴^,⁵, MD, MSc; Natalia Pinilla-Echeverri²^,³^,⁴^,⁵, MD, MSc; Jon David Schwalm²^,³^,⁴^,⁵, MD, MSc; Madhu K. Natarajan²^,³^,⁴^,⁵, MD, MSc; Andrew Kelly³^,⁴^,⁵, MD; Elie Akl⁷, MD; Sarah Tawadros⁴, MBBCh; Mercedes Camargo⁴, MD, MASc; Walaa Faidi⁴, MSc; John Bauer⁴, BMRSc; Rachel Moxham⁴, BSc; James Nkurunziza³^,⁴^,⁵, MD; Gustavo Dutra³^,⁴, MD; Jose Winter⁸, MD; Sanjit S. Jolly²^,³^,⁴^,⁵, MD, MSc

Abstract

Background: Whether ultrasound (US)-guided femoral access compared to femoral access without US guidance decreases access site complications in patients receiving a vascular closure device (VCD) is unclear.

Aims: We aimed to compare the safety of VCD in patients undergoing US-guided versus non-US-guided femoral arterial access for coronary procedures.

Methods: We performed a prespecified subgroup analysis of the UNIVERSAL trial, a multicentre randomised controlled trial of 1:1 US-guided femoral access versus non-US-guided femoral access, stratified for planned VCD use, for coronary procedures on a background of fluoroscopic landmarking. The primary endpoint was a composite of major Bleeding Academic Research Consortium 2, 3 or 5 bleeding and vascular complications at 30 days.

Results: Of 621 patients, 328 (52.8%) received a VCD (86% ANGIO-SEAL, 14% ProGlide). In patients who received a VCD, those randomised to US-guided femoral access compared to non-US-guided femoral access experienced a reduction in major bleeding or vascular complications (20/170 [11.8%] vs 37/158 [23.4%], odds ratio [OR] 0.44, 95% confidence interval [CI]: 0.23-0.82). In patients who did not receive a VCD, there was no difference between the US-...

Forgot your password?

No account yet?
Sign up for free!

Create my pcr account

Join us for free and access thousands of articles from EuroIntervention, as well as presentations, videos, cases from PCRonline.com