Vascular Access Site Complications

Vascular complications are relatively common after endovascular procedures, such as PCI or peripheral vascular interventions. The advent of higher complexity procedures, including percutaneous mechanical circulatory support, demands familiarity of the interventional cardiologist with these complications and their treatment options. The prevention of vascular complications starts with a good vascular access technique. We review the evidence behind different techniques to ensure optimal access. When complications arise, many can be managed with noninvasive measures. However, complications that result in acute vessel obstruction or persistent bleeding may require prompt intervention. Here, we describe a variety of percutaneous management options. However, treatment strategies should always be defined in conjunction with the vascular surgery team to avoid unnecessary heroic percutaneous attempts in lieu of more feasible surgical options.