Timing and predictors of femoral haematoma development after manual compression of femoral access sites

Objective: To identify the timing and predictors of haematoma development after manual compression of femoral arteriotomies. Methods: The study involved 239 consecutive patients undergoing cardiac catheterization at King Abdullah University Hospital, Irbid, Jordan. Size and timing of haematoma development were recorded. A total of 33 prespecified variables were evaluated by univariate analysis to identify predictors of haematoma development. These predictors were again analyzed using multivariate logistic regression model. Results: Femoral haematomas developed in thirty nine patients leading to an overall frequency of 16.3 %. More than two-thirds (74.4%) of the haematomas occurred later in the bed unit. Only 8 among 33 studied variables were found to be significant predictors of haematoma development upon multivariate analysis. These predictors are low haematocrit level before the procedure, advanced age, wider waist circumference, high systolic blood pressure, multiple artery puncture, longer ACT at the end of the procedure, anticoagulant treatment before procedure, and Glycoprotein IIB/IIIa inhibitors use during the procedure. Conclusions: Identifying predictors of haematoma development at femoral access sites and trying to correct or modify them when possible, can have a major impact on reducing the frequency of this serious complication. If an assessment indicates that a patient is at high risk, then several cautious management strategies should be implemented in this setting prior to performing cardiac catheterization.