Julie Parkinson

Master of Philosophy (Nursing)

An evaluation of peripheral vascular access site complications following coronary angiography and percutaneous coronary intervention (PCI)

Supervisors: Dr Tom Buckley, Dr Janice Gullick and Prof Andrea Marshall (external supervisor)

Background

Cardiac angiography and PCI are important invasive procedures in the diagnosis and treatment of coronary heart disease, with PCI continuing to grow rapidly as a therapeutic modality.

Coronary angiography and PCI are not without risk, with a 1% in-hospital death rate associated with PCI’s. However, other complications such as peripheral vascular access site complications may seem innocuous, but can result in significant discomfort to the patient and may complicate recovery.

A review of more than 150 studies from 1989 to 2011 identified important vascular access site complications which include haematoma, bleeding, bruising, pseudoaneurysm, arteriovenous fistula, retroperitoneal bleeding, thromboembolism and infection. The incidence of complications ranged from less than 1% (Eggebrecht et al., 2004) to 76% (Chlan et al., 2005). The literature review identified 25 variables which contribute to peripheral vascular access site complications.

Aims

1. Document the demographic, clinical and procedural factors associated with invasive coronary angiography and PCI complications

2. Identify clinical practice procedures that may reduce potential complications

Methods

A continuous quality improvement project was commenced in 2007 for all patients (n=3000) undergoing coronary angiography and PCI at Gosford Hospital. This study will identify the prevalence of PCI complications and associated risk factors from this data set.

Progress and analysis

A comprehensive review of the literature has been conducted and ethics approval to commence data analysis has been submitted to the local area health service.