Risk and Complications of Cardiac Catheterization and Coronary Intervention

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: 6 June 2024 | Viewed by 2775

Special Issue Editor


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Guest Editor
UOC Cardiology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
Interests: coronary angiography; interventional cardiology; PCI; acute myocardial infarction; atherosclerosis

Special Issue Information

Dear Colleagues,

Cardiac catheterization and Coronary Intervention are nowadays one of the most performed interventional procedures. Despite the great improvements both in device technology and pharmacological strategies, some procedure- and patient-related complications are still possible. The term ‘cardiac catheterization’ can refer both to left and right heart catheterization, and the procedure can be either diagnostic or therapeutic, with a large variety of interventions depending on the clinical need. From the identification of preventive strategies to management of the worst complications, we aim to assess current strengths and weaknesses in performing cardiac catheterization procedures and Coronary Intervention.

In particular, this Special Issue will focus on:

  • Complications of diagnostic left heart cardiac catheterization
  • Complications of percutaneous coronary intervention
  • Complications of right heart cardiac catheterization
  • Preventive measures to avoid complications of cardiac catheterization
  • Complication management strategies

Dr. Lucia Barbieri
Guest Editor

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Keywords

  • cardiac catheterization
  • coronary intervention
  • complications
  • preventive measures
  • patient management
  • patient outcome

Published Papers (2 papers)

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Research

8 pages, 640 KiB  
Article
The “Woggle” Technique for Venous Access Site Management: An Old Technique for a New Need
by Gabriele Tumminello, Lucia Barbieri, Carlo Avallone, Nello Bellissimo, Luca Mircoli, Federico Colombo, Marco Vicenzi, Massimiliano Ruscica and Stefano Carugo
J. Clin. Med. 2023, 12(18), 6087; https://doi.org/10.3390/jcm12186087 - 20 Sep 2023
Cited by 1 | Viewed by 1470
Abstract
Background: Several closure devices are routinely used for percutaneous arterial access, while a relatively low number is available for the management of large bore venous accesses. The Woggle technique is a modification of the purse-string suture which was introduced several years ago in [...] Read more.
Background: Several closure devices are routinely used for percutaneous arterial access, while a relatively low number is available for the management of large bore venous accesses. The Woggle technique is a modification of the purse-string suture which was introduced several years ago in patients undergoing hemodialysis. Methods: A population of 45 patients who underwent transvenous femoral structural heart interventions was retrospectively evaluated. The Woggle technique consists of a purge string suture with a collar to maintain the tension as stable over time and a suture lock to tighten the suture. Results: Sheaths magnitude ranged from 8 French (F) to 14 F. A rapid post-procedural hemostasis was achieved in the whole population, and in 95% of cases, definite hemostasis was obtained after the first single release; the mean time of release was 302 ± 83 min. Although no relevant bleedings were reported, a significant reduction in hemoglobin levels was found in the whole population. This decrement was statistically significant only in the group with sheaths higher than 12 F. A single mild local hematoma was recorded in the group in which smaller sheaths were used. Seventy-two percent of patients were pre-treated with a dual antiplatelet therapy. Conclusions: The Woggle technique has shown to be a simple, effective, and safe approach for the management of large bore venous in percutaneous structural heart interventions. Full article
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8 pages, 742 KiB  
Article
Right Heart Catheterization: An Antecubital Vein Approach to Reduce Fluoroscopy Time, Radiation Dose, and Guidewires Need
by Giuseppe Locatelli, Luca Donisi, Luca Mircoli, Federico Colombo, Lucia Barbieri, Gabriele Tumminello, Stefano Carugo, Massimiliano Ruscica and Marco Vicenzi
J. Clin. Med. 2023, 12(16), 5382; https://doi.org/10.3390/jcm12165382 - 18 Aug 2023
Cited by 1 | Viewed by 826
Abstract
Antecubital access for right heart catheterization (RHC) is a widespread technique, even though there is a need to clarify if there are differences and significant advantages compared to proximal vein access. To pursue this issue, we retrospectively identified patients who underwent RHC in [...] Read more.
Antecubital access for right heart catheterization (RHC) is a widespread technique, even though there is a need to clarify if there are differences and significant advantages compared to proximal vein access. To pursue this issue, we retrospectively identified patients who underwent RHC in our clinic over a 7 year period (between January 2015 and December 2022). We revised demographic, anthropometric, and procedural data, including the fluoroscopy time, the radiation exposure, and the use of guidewires. The presence of any complications was also assessed. In patients with antecubital access, the fluoroscopy time and the radiation exposure were lower compared to proximal vein access (6 vs. 3 min, mean difference of 2 min, CI 95% 1–4 min, p < 0.001 and 61 vs. 30 cGy/m2, mean difference 64 cGy/m2, CI 95% 50–77, p < 0.001). The number of patients requiring the use of at least one guidewire was lower in the group undergoing RHC through antecubital access compared to proximal vein access (55% vs. 43%, p = 0.01). The feasibility was optimal, as just 0.9% of procedures switched from antecubital to femoral access, with a negligible rate of complications. The choice of the antecubital site exhibits advantages, e.g., a shorter fluoroscopy time, a reduced radiation dose, and a lower average number of guidewires used compared to proximal vein access. Full article
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