We included 119 patients who underwent a transfemoral diagnostic cerebral angiogram using a 4-French femoral sheath. In all patients, access was obtained under ultrasound guidance. The mean age was 54 years with (88%) females. Forty-one patients (34%) were on antiplatelet medications, with 12 (10%) on dual antiplatelet therapy (DAPT). Intravenous heparin was not used during any of the procedures and none of the patients was on oral anticoagulation medications. Of all patients, (27%), (31%), (16%), and (26%) had Charleson-Deyo comorbidity score of 0,1, 2, and = > 3, respectively. Four patients (3%) (two on DAPT, one on Aspirin alone, and one was not on any antiplatelet medication) had access-site bleeding complications after 15 min of manual compression. In all four patients, the bleeding can be characterized as a small leaking of blood from the groin puncture site that required additional compression to achieve hemostasis with no further intervention. Also, one of these patients presented with delayed hematoma due to a small pseudoaneurysm, which was treated conservatively. Also, the analysis of individual groups showed that in patients on single or no antiplatelet medications, the rate of access site bleeding complications was (1.7%) hematoma [Tables
1 &
2]. Moreover, within the DAPT, single antiplatelet agent, and no antiplatelet medications groups, (17%,
N = 2), (3%,
N = 1), and (1%,
N = 2) of patients developed access site hematoma, respectively. Comparative analysis revealed no significant difference in age (
p = 0.1) and comorbidity score (
p = 0.1) among the three groups. Correlation analysis revealed a significant correlation between the use of antiplatelet agents and the occurrence of access site hematoma (OR = 4, 95% CI:1.1–14.7,
p = 0.03). Moreover, there were no occurrences of major complications (e.g., retroperitoneal hematoma), arteriovenous fistula, or femoral artery dissection.
Table 1
Demographics of the study population
Age (years) | Range | 19–86 | | |
Avg | 54 | | |
Gender | Male | | 14 | 12% |
Female | | 105 | 88% |
Antiplatelets | DAPT | | 12 | 10% |
ASA or Plavix | | 29 | 24% |
CCI | 0 | | 32 | 27% |
1 | | 37 | 31% |
2 | | 19 | 16% |
= > 3 | | 31 | 26% |
Table 2
Details of access-site complications
Groin hematoma | DAPT group | 2 | 17% |
ASA or Plavix group | 1 | 3% |
No antiplatelets group | 1 | 1% |
Total | 4 | 3% |
Femoral artery pseudoaneurysm | | 1 | 0.8% |