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Retroperitoneal hematoma found an uncommon complication of PCI
Trimarchi S. J Am Coll Cardiol Intv. 2010;3:845–850.
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Retroperitoneal hematoma was not a common complication of contemporary percutaneous coronary intervention, although it was associated with high morbidity and mortality in a study examining patients from a large, multicenter registry.
Researchers analyzed 112,340 patients from the Blue Cross Blue Shield of Michigan Cardiovascular Consortium registry who were undergoing PCI between October 2002 and December 2007. The evaluated endpoints included the development of retroperitoneal hematoma and mortality.
Of the 482 (0.4%) patients with retroperitoneal hematoma, 92.3% were treated medically and 7.7% underwent surgical repair. Independent predictors of retroperitoneal hematoma included: female sex, body surface area of less than 1.8 m², emergency procedure, history of chronic obstructive pulmonary disease, cardiogenic shock, pre-procedural IV heparin, pre-procedural glycoprotein IIb/IIIa inhibitors, adoption of sheath size of at least 8-French, and use of vascular closure devices.
Furthermore, researchers noted that retroperitoneal hematoma development correlated with a higher frequency of post-procedure MI (5.81% vs. 1.67%), infection and/or sepsis (17.43% vs. 3%), HF (8% vs. 1.63%) and in-hospital mortality (6.64% vs. 1.07%; P<.0001 for all) vs. those who did not develop retroperitoneal hematoma.
These findings, the researchers wrote, “[agree] with previous literature suggesting that [retroperitoneal hematoma] is an uncommon complication in patients undergoing PCI … and confirm the association between the development of [retroperitoneal hematoma] and a significantly higher risk of morbidity and mortality. Although it remains to be determined, the identification of risk factors for the development of [retroperitoneal hematoma] could lead to modification of procedure strategies aimed toward reducing its incidence, such as the adoption of a radial artery approach in high-risk patients.”
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