A new preprocedural score to predict bleeding complications of endovascular peripheral arterial interventions

Postgraduate Thesis uoadl:2880439 284 Read counter

Unit:
Κατεύθυνση Επεμβατική Ακτινολογία
Library of the School of Health Sciences
Deposit date:
2019-09-04
Year:
2019
Author:
Tsochatzis Athanasios
Supervisors info:
Σταύρος Σπηλιόπουλος, Επίκουρος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ, Επιβλέπων
Ηλίας Μπρούντζος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Ευθυμία Αλεξοπούλου, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Ένα νέο προ-επεμβατικό σκορ για την πρόβλεψη αιμορραγικών επιπλοκών των ενδαγγειακών περιφερικών αρτηριακών επεμβάσεων
Languages:
Greek
Translated title:
A new preprocedural score to predict bleeding complications of endovascular peripheral arterial interventions
Summary:
Purpose
To investigate the bleeding complications of endovascular peripheral arterial interventions (EPAI) and develop a dedicated peripheral bleeding score (PBS).
Materials and Methods
This prospective, single center, study included all therapeutic EPAI performed between August 2016 and July 2018 for the treatment of chronic atherosclerotic arterial disease. Primary endpoints were the incidence of periprocedural (30-day) bleeding complications (PBC), the identification of factors associated with bleeding events and the development of a dedicated PBS. Secondary outcome measure included the comparison between the HAS-BLED score and the PBS.
Results
In total 530 procedures were included (mean age 67.6 ± 9.8 years; male: 74.7%).
The overall PBC rate was 3.77% (20/530 procedures). Major PBC rate was 3.2% (17/530 procedures) and included retroperitoneal active bleeding (0.75%) and pseudoaneurysms (2.45%). The annualized incidence of overall bleeding and major PBC were 1.88% and 1.6%; respectively. Multivariable regression analysis identified that age≥75 was correlated with a significantly increased bleeding risk [HR: 3.32; 95%CI:1.12-9.80; p<0.02]. Male gender [HR: 0.193; 95%CI: 0.49-0.75; p<0.001] and statin therapy [HR: 0.245; 95%CI:0.08-0.71; p =0.01] were correlated with a significantly decreased bleeding risk. Based on the regression analysis findings an eight-point PBS was developed, demonstrating 75.0% sensitivity and 78.4% specificity in detecting PBC. The HAS-BLED score failed to identify PBC.
Conclusions
The annual incidence of bleeding complications of EPAI was low. Advanced age and female gender were correlated with increased bleeding risk. PBS demonstrated satisfactory statistical performance and could be considered for inclusion in the pre-procedural endovascular checklist in order to contribute to the optimization of intra-and post-procedural care.
Main subject category:
Health Sciences
Keywords:
Bleeding complications, Peripheral arterial endovascular procedures, HAS-BLED score, Peripheral bleeding score
Index:
No
Number of index pages:
0
Contains images:
Yes
Number of references:
88
Number of pages:
57
File:
File access is restricted only to the intranet of UoA.

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