Key result
Femoral artery access increased total puncture site complications compared to radial access in first-time PCI patients.
Why the study?
The multifactorial interactive risk characteristics of puncture site complications after PCI and a quantitative risk assessment model based on real-world data needed to be explored and established.
Do advanced age, renal insufficiency, dual antiplatelet therapy, and femoral artery access increase the risk of post-PCI puncture site complications in patients undergoing first-time percutaneous coronary intervention?
Cohort (n=500)
No
Do advanced age, renal insufficiency, dual antiplatelet therapy, and femoral artery access increase the risk of post-PCI puncture site complications in patients undergoing first-time percutaneous coronary intervention?
Advanced age, renal insufficiency, and dual antiplatelet therapy synergistically increase post-PCI vascular access complications alongside femoral access, and a risk model integrating eGFR, BMI, and antiplatelet therapy (AUC 0.82) can guide individualized post-procedural compression management.
Answers are grounded in this paper and cite their sources.
Radial access may lower puncture complications in first-time PCI; extends observational support for radial preference but leaves risk model adoption open.
目的：探讨冠脉介入术后穿刺部位并发症的多因素交互风险特征，构建基于真实世界数据的量化风险评 估模型。方法：采用回顾性队列设计，纳入首次接受经皮冠状动脉介入治疗患者500例，按是否发生血肿、假性动脉 瘤或动静脉瘘分为观察组与对照组，经倾向性评分匹配后，结合Logistic回归分析高龄、肾功能不全与抗血小板治疗的 独立及交互效应，比较股动脉与桡动脉入路的并发症差异，并验证风险评分模型的校准性与判别效能。结果：高龄与 肾功能不全存在协同增毒效应，双联抗血小板治疗为独立风险因子，三者交互作用提升并发症风险；股动脉入路较桡 动脉入路增加总并发症及血肿、假性动脉瘤风险，对动静脉瘘影响无统计学差异；基于上述变量构建的风险评分模型 区分能力（AUC = 0.82）与校准性良好。结论：高龄、肾功能不全及双联抗血小板治疗构成复合风险结构，股动脉入 路为独立高危因素，该模型可为个体化压迫管理与护理路径精准化提供依据。
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范琼飞 (2026) conducted a cohort in Patients undergoing first-time percutaneous coronary intervention (PCI) (n=500). Femoral artery access (along with advanced age ≥75 years, renal insufficiency eGFR <60 mL/min, and dual antiplatelet therapy) vs. Radial artery access (and younger age <75 years, eGFR ≥60 mL/min, single antiplatelet therapy) was evaluated on Total post-PCI puncture site complications (hematoma, pseudoaneurysm, or arteriovenous fistula) (OR 2.31, 95% CI 1.87-2.85, p=<0.001). Femoral artery access increased total puncture site complications compared to radial access in first-time PCI patients.
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