Predictors of complications after a prospective evaluation of diagnostic and therapeutic endovascular procedures

J Vasc Surg. 2004 Dec;40(6):1142-8. doi: 10.1016/j.jvs.2004.09.024.

Abstract

Objective: To prospectively evaluate complications after diagnostic and therapeutic endovascular procedures (DTEPs) and determine what factors are predictive.

Methods: From December 2002 to December 2003, all patients undergoing DTEPs performed by university vascular surgeons in a catheterization laboratory were prospectively evaluated. Medical demographics, procedure-related details, and type and severity of complications were recorded at the time of the procedure, during the first 24 hours, and at 2 to 4 weeks. Complications were classified as local vascular (LV), local nonvascular (LNV), systemic remote (SR), and major, minor, and nonsignificant.

Results: Three hundred-three DTEPs were performed (54.5% DEPs, 45.5% TEPs). At the time of DTEP, 28 complications occurred in 23 patients: 10 LV (3.3%), 15 LNV (5.0%), and 3 SR (1.0%). At 24 hours, 26 complications occurred in 25 patients: 5 LV (1.7%), 7 LNV (2.3%), and 14 SR (4.7%). At 2 to 4 weeks, 26 complications occurred 25 patients: 5 LV (1.7%), 7 LNV (2.3%), and 14 SR (4.7%). The combined major (7.3%) and minor (4.3%) complication rate attributed to DTEPs was 11.6%. Significant predictors (P < .05) by multivariate analysis included thrombolysis, prior stroke, an additional procedure during the study period, and diabetes mellitus (odds ratios: 9.1, 3.2, 2.7, and 2.4, respectively).

Conclusion: According to newly applied reporting standards, the prospective evaluation of DTEPs reveals that complications are uniformly distributed by type and follow-up period. Just over 1 in 10 patients will suffer either a major or minor complication. Potential predictors have been identified that may assist in patient selection and treatment plans to lower complications resulting from DTEPs.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Catheterization*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications*
  • Predictive Value of Tests
  • Prospective Studies
  • Risk Factors
  • Vascular Diseases / diagnosis
  • Vascular Diseases / therapy