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© 2009 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 28:1151-1157 • 0278-4297

Sonographic Follow-up of the Access Site After Arterial Angiography

Impact on the Detected Complication Rate

Alexandra Meis, MD, Nani Osada, PhD, Philip M. Schlegel, MD, Roman Fischbach, MD, Walter Heindel, MD and Stephan P. Kloska, MD

Departments of Clinical Radiology (A.M., P.M.S., R.F., W.H., S.P.K.) and Medical Informatics and Biomathematics (N.O.), University of Muenster, Muenster, Germany.

Address correspondence to Stephan P. Kloska, MD, Department of Clinical Radiology, University of Muenster, Albert-Schweitzer-Strasse 33, 48149 Muenster, Germany. E-mail: kloska{at}uni-muenster.de

Objective. This study prospectively evaluated the impact of sonographic follow-up on the detection rate of access site complications in arterial angiography and determined parameters associated with major complications of the access site after arterial angiography. Methods. Sonographic follow-up (mean ± SD, 1.46 ± 1.11 days after) of the access site (transfemoral, n = 896; and transbrachial, n = 44) was obtained prospectively in 940 arterial angiographies and included evaluations for hematoma, pseudoaneurysm, arteriovenous fistula, arterial dissection, and venous/arterial thrombosis. Clotting parameters, anticoagulation therapy, and several patient and procedure characteristics were recorded. Univariate and multivariate logistic regression analyses were performed. Results. Sonography depicted major access site complications in 39 of 940 angiographies (4.2%). Major access site complications (major local hematoma, n = 13; retroperitoneal hematoma, n = 1; pseudoaneurysm, n = 18; arterial dissection, n = 1; arteriovenous fistula, n = 1; arterial thrombosis, n = 2; and venous thrombosis, n = 3) required conservative (n = 32 [3.4%]) or surgical (n = 7 [0.7%]) treatment. Independent factors significantly associated with major access site complications were age older than 60.33 years and sheath size greater than 5F (P < .05). Conclusions. Major access site complications were detected in 4.2% of cases and were significantly associated with age and sheath size.

Key Words: access site • angiography • complications • operator experience • sonography

Abbreviations: CI, confidence interval • CM, contrast medium • INR, international normalized ratio • OR, odds ratio • PTT, partial thromboplastin time

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