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Introduction: Vascular access-site complications following percutaneous interventions done using femoral approach, are an important cause of mortality, morbidity, prolonged stay and greater cost burden. Aim: To study the incidence and the factors which predict femoral artery access vascular complication after catheterisation in North Indian population. Materials and Methods: This was a prospective longitudinal observational study conducted at Department of Cardiology SMS Medical College at Jaipur, Rajasthan,India between April 2016 to November 2017. All patients (n=11200) who underwent catheterisation from the femoral approach from April 2016 till November 2017 in the study institute were included. Duplex ultrasound was performed in cases with clinical suspicion of vascular complications. Clinical data and procedural variables were compared with a control group of 100 randomly selected patients. Univariate analysis and a logistic regression model for multivariate analysis for predicting independent variable was performed. results: Femoral artery access vascular complication incidence rate was 2.05% (230). Complications rate was higher for interventional procedures (3.6%) than diagnostic procedures (1.25%). The most common vascular complication was haematoma which was seen in 1.29% (145) patients, other complication were femoral artery venous fistula seen in 0.37% (42) patients, pseudo-aneurysm in 0.41% (46) patients, acute limb ischemia in 0.1% (12) and infection in 0.09% (11) patients. It was found that advanced age (>60 years), female gender, obesity and hypertension were predictors of complication. Patients who received thrombolytic agent or low molecular weight heparin prior to procedure, use of large sheath size (7F v/s 6F) and multiple puncture to achieve femoral artery access were also independent predictors of vascular complication. Diabetes mellitus and duration of manual compression had no impact on vascular complication. conclusion: Femoral artery access vascular complication is not uncommon following diagnostic or interventional cardiac catheterisation. The strongest predictors of vascular complication were advanced age (>60 year), female gender, overweight & obesity, hypertension, use of thrombolytic agent or anticoagulant prior to procedure, large size sheath 7F, and multiple puncture. Use of smaller sheaths, improved access techniques, safer antithrombotic therapy and use of vascular closure devices may be helpful for prevention of these vascular complications. [ABSTRACT FROM AUTHOR]

Objective: Pseudoaneurysms (PSAs) of the internal carotid artery (ICA) and vertebral artery are rare entities but with varied treatment options. PSAs can be spontaneous or secondary to trauma, infections, malignancies or iatrogenic. To find out the efficacy of various endovascular interventions in the management of ICA and vertebral PSAs. Methods: The study included 14 patients diagnosed with intracranial PSAs who underwent endovascular interventions in SMS Medical College, Jaipur (Rajasthan) between June 2015 to January 2019. The clinical and radiological findings (computed tomography angiography and digital subtraction angiography) were reviewed and the consequent endovascular intervention carried out and their results were analyzed. Results: Total 14 patients were studied out of which 8 (57.1%) were anterior circulation PSAs and 6 (42.9%) were posterior circulation PSAs There were 10 (71.4%) females and 4 (28.5%) males between the age of 9 to 65 years. Only 2 patients with PSA had past history of trauma. Coiling was done in 8 patients (57.1%), stenting in 2 patients (14.2%), parent artery occlusion in 1 patient (7.1%), glue embolization in 1 patient (7.1%) while coiling with glue in 1 patient (7.1%) and flow diverter in 2 patients (14.2%). Immediate and complete occlusion was achieved in 11 (78.6%) patients while 3 (21.4%) patients had subtotal occlusion. 11 patients under follow up till June 2019 did not report recurrence or new neurological deficit. Conclusions: Endovascular interventions is minimally invasive and safe treatment strategy for intracranial PSAs. The ultimate choice of technique depends on clinical and imaging characteristics. [ABSTRACT FROM AUTHOR]