Are Vascular Closure Devices Risk Factors For Retroperitoneal Hemorrhage?
Retroperitoneal hemorrhage (RPH) is a potentially fatal complication and is most often related to invasive cardiac procedures using the femoral artery access route. RPH rarely occurs spontaneously. For cardiac cath procedures, RPH is more often related to a cranially positioned (high) arterial puncture, a location which cannot be determined with certainly beforehand since femoral anatomy is variable and the puncture technique is performed in a blind manner (i.e. no ultrasound guidance). RPH is most commonly seen in association with patients with anticoagulation therapy, bleeding abnormalities and hemodialysis. The incidence of retroperitoneal hematoma has been reported at 0.6-6.6% of patients undergoing therapeutic anticoagulation. Warfarin, unfractionated and low-molecular weight heparins have all been associated with RPH. Interestingly, the risk of bleeding during unfractionated heparin therapy has been estimated to be two- to five-fold greater than that with warfarin. As an aside, s
