PERIPROCEDURAL COMPLICATIONS
Table 3 summarizes overall periprocedural complications. 3
intra-procedural deaths occurred, all of which underwent laser
extraction from a superior approach. The femoral group experienced lower
30-day mortality, although not statistically significant[2/49(4%) vs
33/372(9%);p=0.39].
Major complications(without intraprocedural death) were observed in 3%
of patients undergoing TLE(14/421). Femoral bailout was associated with
a higher percentage of major complications without intraprocedural
mortality[5/49(10.2%) vs 9/369(2.4%);p=0.015]. We experienced 9
vascular and cardiac tears of which 4 were directly related to femoral
approach tool deployment(none resulted in fatalities). Serious TR
complications as a result of extraction occurred in 7 patients of whom
only one patient required femoral TLE. Five minor
complications(including pocket hematoma, femoral vein tear, pulmonary
emboli, and minor TR) were encountered: 4 of which were associated with
the femoral bailout group, compared to one in the superior approach
group[4/49(8.2%) vs 1/372(0.3%);p<0.01].
Femoral bailout patients required more blood transfusion
peri-procedurally[9/49 (18%) vs 14/372(3.8%);p<0.01],
however, this did not translate into excess in mortality.
Extraction in occluded veins via a superior approach resulted in major
complications in 16%[3/19(15.7%)] of the cases, while shifting to
a femoral strategy in these patients did not result in additional major
complications.