Haemorrhagic complications of femoral artery pseudoaneurysms caused by interventional cardiology procedures - a large-population retrospective study

Introduction: For many years femoral access was the preferred approach in interventional cardiology. Still, due to its large size, which allows for the use of larger catheters, the femoral artery remains the preferred access for many procedures. Femoral pseudoaneurysms are the most common and most severe complication of this access.Aim of the research: To evaluate haemorrhagic complications of femoral pseudoaneurysms induced by interventional cardiology procedures.Material and methods: From the patients treated with percutaneous intervention between 2006 and 2022 in the Second Department of Cardiology, Swietokrzyskie Cardiology Centre, Kielce, Poland, we registered and analysed 621 cases of femoral pseudoaneurysms. Of these patients, 537 had their haemoglobin tested before and after the procedure, and they constitute the population thoroughly analysed in the study.Results and conclusions: The occurrence of a pseudoaneurysm statistically significantly increased the chance of any decrease in haemoglobin (HGB) (OR = 3.26, 95% CI: 2.26-4.7, p < 0.0001), as well as a decrease in HGB by more than one unit (OR = 6.34, 95% CI: 4.87-8.26, p < 0.0001), a decrease in HGB by more than 2 units (OR = 7.54, 95% CI: 5.18-10.96, p < 0.0001), or a decrease in HGB by more than 3 units (OR = 20.31, 95% CI: 9.35-44.1, p < 0.0001). Among patients who had any decrease in HGB after the procedure, significantly greater average decreases were observed in the group of patients with a pseudoaneurysm. Men were significantly more likely to be anaemic before the procedure. Among the patients with femoral pseudoaneurysm whose HGB levels dropped the most after percutaneous intervention, STEMI was the most common primary condition. The occurrence of a pseudoaneurysm significantly increased the risk of anaemia.