Assessment of Vascular Complication and Associated Factors Among Patients who Underwent Cardiac Catheterization, A retrospective study at Ethiopian Cardiac Center, Addis Ababa, Ethiopia, 2025

Assessment of Vascular Complication and Associated Factors Among Patients who Underwent Cardiac Catheterization, A retrospective study at Ethiopian Cardiac Center, Addis Ababa, Ethiopia, 2025 | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Assessment of Vascular Complication and Associated Factors Among Patients who Underwent Cardiac Catheterization, A retrospective study at Ethiopian Cardiac Center, Addis Ababa, Ethiopia, 2025 Sosina Dejene, Deribew Awoke, Niguse Tadele, Nete Tewfik This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9224661/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 7 You are reading this latest preprint version Abstract Background: Cardiac catheterization is an invasive procedure performed for diagnosing and treating heart conditions. Its invasive nature can lead to various complications. Vascular complications have been recognized as significant contributors to post-procedural morbidity. They also contribute to increased patient discomfort, prolonged hospital stays, higher treatment costs, and negative patient outcomes. Several studies in other setting have shown that the rate of major vascular complications ranges from 0.3% to 1%. However, their prevalence in Ethiopia remains unknown. Objective : This study aims to determine the prevalence of vascular complications and identify associated risk factors among patients who underwent cardiac catheterization in Ethiopian Cardiac Center, Addis Ababa, Ethiopia, 2025. Methods: A document review was conducted from January 1, 2020, to December 31, 2024, at the Ethiopian Cardiac Center. A total of 305 patient records were selected using systematic random sampling. Data were collected through structured checklists and analyzed using SPSS version 26. Binary logistic regression analyses were performed to identify factors associated with vascular complications. Adjusted odds ratios (AORs) with 95% confidence intervals (CI) and p-values < 0.05 were considered statistically significant. Results: The prevalence of vascular complications was 15.1%. The most common complications included hematoma (4.6%), hemorrhage (3.6%), and thromboembolism (1.0%). In Multivariable regression, patients who are females, overweight, and had previous catheterization (AOR = 4.07, 95% CI: 1.50–11.02, P = 0.006), underweight BMI (AOR = 5.31; 95% CI: 1.38–20.32; p = 0.015), and no previous catheterization (AOR = 5.26; 95% CI: 1.59–17.36; p = 0.006) were the significant variables. Conclusion: the study shows moderate prevalence of vascular complication and also the risk of complications was significantly higher in female patients, those who were overweight, and those with aprevious catheterization. Vascular complication and Cardiac catheterization Figures Figure 1 Introduction Cardiac catheterization is an invasive procedure used to diagnose and treat heart conditions. It is the primary method for diagnosing and managing coronary artery diseases ( 1 , 2 ). Over time, the criteria for cardiac catheterization have expanded from primarily low-risk patients to include those with complex coronary diseases and high-risk situations, such as acute coronary syndromes( 3 ). Its invasive nature can lead to various complications. The most frequent complications are vascular, which can lead to increased discomfort, longer hospital stays, and poorer patient outcomes. Vascular complication refers to problems that arise in the blood vessels ( 1 , 2 ). To address this, multiple studies have been conducted to help cardiologists identify, report, and monitor these complications, aiming to establish performance standards for catheterization labs( 4 ). Cardiac catheterization is performed through the radial and femoral artery approach. The radial artery is often linked to vascular complications, but these have less occurrence when compared to the femoral approach( 5 ). Injuries to the femoral artery are common following diagnostic and therapeutic cardiac catheterizations( 6 ). Vascular complications have been recognized as significant contributors to post-procedural morbidity. Recent research highlights that bleeding after cardiac catheterization is a notable source of complications that lead mortality( 7 ). Common major and minor complications associated with femoral artery access include: hematomas, arteriovenous fistulas (AVF), pseudoaneurysms, retroperitoneal hematomas, and external bleeding, femoral artery dissection, loss of pulse to the distal extremity, mycotic aneurysms (major complication) and ecchymosis, mild bleeding and swelling (minor complication)( 8 ). Large-scale studies of cardiac catheterization have found that the rate of major vascular complications ranges from 0.3% to 1%. Complications related to vascular access occur in 0.8% to 1.8% of diagnostic cardiac catheterizations, and between 1.5% and 9% of cases involving percutaneous coronary interventions (PCI) performed through the trans-femoral approach( 9 , 10 ) Vascular complications following cardiac catheterization vary based on technological and economic development. High-income countries experience fewer vascular complications compared to countries with middle- and low-income economies. These prevalence have been reported as follows: 1% in the northeastern US, 10.5% in Virginia (USA), 32.4% in Canada, 36% in Sweden, 53.3% in Greece, and 66% in Egypt ( 1 , 9 , 13 – 16 ). Despite advancements in techniques and technologies designed to reduce complications, there remains a significant occurrence of vascular complications after cardiac catheterization( 11 ). The differences in complication rates among various patient populations indicate that certain risk factors—such as age, female sex, obesity, smoking, coexisting conditions like hypertension, renal failure, diabetes mellitus, recent myocardial infarction, as well as the use of large sheaths, excessive coagulation, and hemodynamic instability are linked to an increased risk( 2 , 8 ). There is a limited study, even not directly related to the topic the prevalence of vascular complication remained unknown. This finding will contribute to health care providers implement more targeted interventions to prevent these complications, to reduce costs associated with post-cardiac catheterization care, to developing guidelines and protocols for the prevention and management of vascular complications in post-cardiac catheterization patients, help policymakers to standardize care practices and improve overall patient safety. It can also highlight areas for quality improvement in post-cardiac catheterization care, leading to better patient outcomes and higher standards of care. Methods and Materials Study design, area and population A retrospective cross sectional study was conducted from January 20 to February 20, 2025 in Ethiopian cardiac center in Addis Ababa, Ethiopia. All adult patients who underwent cardiac catheterization in Ethiopian cardiac center from January 1, 2020 to December 31, 2024, and with full information/medical records were included except patients who have unclear and unreadable information in the record. The sample size was calculated using a single population proportion formula based on the assumptions of the 95% confidence level, 5% margin of error, and 66% population proportion taken from the study done in Egypt. A total of 305, with a 100% data retrieval rate was consented. Systematic random sampling technique was used to select study subjects from the study population after a sampling frame list of the study population was prepared from the procedure registration book of the study period. To select patients document K interval was calculated and obtained 5 the first document selected by simple random sampling method. Dependent variables Vascular complication following cardiac catheterization Independent variables Socio demographic factor (Age, Gender, Body mass index, Occupation), Medical history (History of cardiovascular disease, History of DM, History of chronic kidney disease, Previous cardiac catheterization), Procedural and behavioral factors (Access site, Duration of the procedure, Use of anticoagulants, Smoking status, Alcohol consumption, Size of sheath, Type of procedure) Data collection tool, procedure and quality control The data was gathered from medical records using structured data extraction checklists. Data were collected by using a pre-tested checklist. A pre-test was done on 5% of the study population (15 adult post cardiac catheterization patients) at Tikur Anbessa Specialized Hospital in Addis Ababa, Ethiopia. The result of the pre-test was used to correct some unclear ideas and statements and the data was not incorporated into the main result. The questions addressed were three sections socio demographic characteristics, vascular complication and related risk factors. The data were collected by two trained professional nurses under the supervision of one supervisors and a principal investigator. Data analysis and processing The data were cleaned and coded to prepare it for processing and analysis. SPSS version 26 software were employed for this analysis. Descriptive statistics summarized the result in percentages and frequencies. In statistical analysis binary logistic analysis were done. Initially, bi-variable analysis were used to identify candidate significant independent variables that have association with independent and dependent variables. Factors showing an association with a p-value less than 0.25 were selected for multivariable logistic regression analysis to account for confounding variables. The strength of associations among the independent variables in relation to the dependent variable was assessed using adjusted odds ratios (AOR) along with a 95% confidence interval, with p-values below 0.05 deemed statistically significant. Ethical approval and consent Ethical approval was obtained from the Institutional Review Board of department of Nursing, Addis Ababa University (IRC-N AAU) with protocol number 166/22. Permission to access the data was secured from Ethiopian Cardiac Center. The study was conducted using secondary data extracted from patient medical records, and no direct contact with participants occurred. Informed consent was waived by the IRB due to the retrospective nature of the study and the use of anonymized data. Confidentiality was maintained by excluding personal identifiers and coding the data. All data were stored securely and accessed only by the research team. The study adhered to the principles of the Declaration of Helsinki. Result Socio-demographic Characteristics A total of 305 eligible documents engaged in the study, yielding a response rate of 100% (305/ 305).The study sample included 182 (59.7%) females and 123 (40.3%) males. The mean age of patients was 38 ± 17.33 years. Approximately half of the patients were between the ages of 18 and 34 years. In terms of occupation, 155 (50.8%) patients were not working, while 79 (25.9%) were daily laborers and 71 (23.3%) were office workers. Regarding body mass index (BMI) the mean was 22 ± 4.68, 91 (29.8%) patients were underweight, 149 (48.9%) had normal weight, 43 (14.1%) were overweight, and 22 (7.2%) were classified as obese. (Table 1 ) Table 1 Socio-demographic characteristics of patients who underwent cardiac catheterization (n = 305) Variables Frequency Percent Gender Female 182 59.7% Male 123 40.3% Age Group interval 18–34 163 53.4% 35–50 69 22.6% 51–66 49 16.1% 67–82 24 7.9% Occupation Daily laborer 79 25.9% Not working 155 50.8% Office working 71 23.3% BMI Group 29.9 (obesity) 22 7.2% Information on vascular complication Out of the 305 patients included in the study, 46 (15.1%) experienced vascular complications following the procedure, while the majority, 259 (84.9%) patients did not report any such complications (Fig. 1 ). Regarding the minor types of vascular complications, 7 (2.3%) patients experienced ecchymosis and 11 (3.6%) had mild bleeding. In terms of major vascular complications, 14 (4.6%) developed hematomas, 3 (1.0%) had thromboembolism, and 11 (3.6%) suffered from hemorrhage. (Table 2 ) Table 2 Vascular Complications faced among patients who underwent cardiac catheterization (n = 305) Complication Type Subcategory Frequency Percent Minor Complications None 287 94.1% Ecchymosis 7 2.3% Mild bleeding 11 3.6% Major Complications None 277 90.8% Hematoma 14 4.6% Thromboembolism 3 1.0% Hemorrhage 11 3.6% Medical factors of patients Among the patients document, several had pre-existing medical conditions. The most frequently reported condition was coronary artery disease, present in 61 (27.0%) individuals, followed by hypertension in 58 (25.7%) individuals, and diabetes mellitus in 44 (19.5%) individuals. A history of hypercholesterolemia was reported by 25 (11.1%) patients and atrial fibrillation by 22 (9.7%). Fewer patients reported a history of myocardial infarction 9 individuals (4.0%) and chronic kidney disease 7 individuals (3.1%). These figures represent the number of respondents who indicated “yes” to each condition, with percentages calculated from the total valid responses. Notably, due to multiple conditions being reported by some patients, the total percentage exceeds 100%. (Table 3 ) Table 3 Medical history of patients who underwent cardiac catheterization (n = 305) Medical Condition Frequency (N) Percent (%) Percent of Cases (%) History of Coronary Artery Disease (CAD) 61 27.0% 52.1% History of Hypertension 58 25.7% 49.6% History of Diabetes Mellitus (DM) 44 19.5% 37.6% History of Hypercholesterolemia 25 11.1% 21.4% History of Atrial Fibrillation (A-fib) 22 9.7% 18.8% History of Myocardial Infarction (MI) 9 4.0% 7.7% History of Chronic Kidney Disease 7 3.1% 6.0% Total 226 100.0% 193.2% * Procedural and behavioral factors of patients Among the 305 patient documents, only 6 (2.0%) had a history of smoking, and 4 (1.3%) reported alcohol consumption, indicating that such lifestyle risk factors were rare in the study population. A previous cardiac catheterization was 24 (7.9%) patients, while the majority, 281(92.1%), and were undergoing the procedure for the first time. Regarding the vascular access site, the femoral artery was used in 285 (93.4%) patients, whereas the radial artery was accessed in 20 (6.6%) patients The purpose of catheterization was predominantly interventional (81.3%), with diagnostic procedures accounting for the remaining 18.7%. The most common procedure performed was percutaneous trans-venous mitral commissurotomy/percutaneous mitral balloon commissurotomy (PTMC/PMBC), done in 158 (51.8%) cases, followed by coronary angiography (57, 18.7%) and PCI (33, 10.8%). Less frequent procedures included BPV (25, 8.2%), ASD device closure (19, 6.2%), PDA device closure (11, 3.6%), and coarcoplasty (2, 0.7%). In terms of sheath size, 57.4% of procedures used 4–6 Fr sheaths, 41.0% used 7–8 Fr, and a small fraction used 9–10 Fr (0.7%) or > 10 Fr (1.0%). Most procedures (78.0%) lasted between 30 minutes and 1 hour, while 12.8% exceeded 1 hour, and 9.2% were completed within 30 minutes. Nearly all procedures (99.0%) involved a single femoral or radial puncture, with multiple punctures being extremely rare. Regarding anticoagulation, Heparin alone was used in the vast majority of cases 257(84.2%), followed by combinations such as Heparin with Clopidogrel 42(13.8%) and Heparin with Clopidogrel and Aspirin 6(2%). (Table 4 ) Table 4 Summary of Lifestyle, Catheterization, and Procedural Characteristics of patients underwent cardiac catheterization (n = 305) Category Subcategory Frequency Percent Smoking No 299 98.0% Yes 6 2.0% Alcohol Use No 301 98.7% Yes 4 1.3% Previous Catheterization No 281 92.1% Yes 24 7.9% Access Site Femoral 285 93.4% Radial 20 6.6% Purpose of Catheterization Interventional 248 81.3% Diagnostic 57 18.7% Type of Procedure PTMC/PMBC 158 51.8% Coronary Angiography 57 18.7% PCI 33 10.8% BVP 25 8.2% ASD D/C 19 6.2% PDA D/C 11 3.6% Coarcoplasty 2 0.7% Sheath Size 4–6 Fr 175 57.4% 7–8 Fr 125 41.0% > 10 Fr 3 1.0% 9–10 Fr 2 0.7% Procedure Duration 30–60 minutes 238 78.0% > 1 hour 39 12.8% 30 minutes 28 9.2% Puncture Frequency Single femoral/radial puncture 303 99.3% Multiple femoral/radial puncture 2 0.7% Anticoagulant Used Heparin only 257 84.2% Heparin + Clopidogrel 42 13.8% Heparin + Clopidogrel + Aspirin 6 2.0% Factors associated with vascular complication among patients underwent cardiac catheterization The following socio-demographic, medical, procedural and behavioral factors were analyzed. Among these; gender, age, occupation, BMI, history of alcohol use, history of hypercholesterolemia, history of DM, history of hypertension, previous cardiac catheterization, size of sheath, time taken for the procedure, sheath removal time and type of anticoagulant used were significant at P < 0.25 by bi-variable analysis. All these factors were entered to multivariable analysis by controlling the effect of confounding factors gender, BMI and previous cardiac catheterization were found to have significantly high odds of vascular complication at P < 0.05. Female patients were 4 times more likely to experience vascular complications compared to males (AOR = 4.07, 95% CI: 1.50–11.02, P = 0.006). Patients with BMI of25–29.9 (overweight) had 5.3 times higher odds of developing vascular complications compared to those with a BMI of < 18.5 (AOR = 5.31, 95% CI: 1.38–20.32, P = 0.015). Additionally, patients with a previous cardiac catheterization were nearly 5.2 times more likely to experience vascular complications than those without such a history (AOR = 5.26, 95% CI: 1.59–17.36, P = 0.006). (Table 5 ) Table 5 Bi-variable and multivariable analysis of factors associated with vascular complication in patients who underwent cardiac catheterization (n = 305) Variable Category Vascular complication COR (95% CI) P-value AOR(95% CI) P-Value Yes no Gender Male 13(4.2%) 110(36%) 1 1 1 1 Female 33(10.8%) 149(49%) 1.87(0.94–3.72) 0.073 ** 4.07(1.503–11.024) 0.006 * Age 18–34 18(5.9%) 145(47.5%) 1 1 1 1 35–50 12(3.9%) 57(18.7%) 1.69(0.76–3.74) 0.191 ** 1.227(0.397–3.792) 0.723 51–66 12(3.9%) 37(12%) 2.6(1.15–5.9) 0.021 ** 1.445(0.297–7.03) 0.648 67–82 4(1.3%) 20(6.5%) 1.6(0.49–5.24) 0.428 0.183(0.019–1.805) 0.146 Occupation Daily laborer 7(2.3%) 72(23.6%) 1 1 1 1 Not working 23(7.5%) 132(43.3%) 1.79(0.73–4.37) 0.201 ** 1.72(0.44–6.707) 0.433 Office working 16(5.2%) 55(18%) 2.99(1.15–7.77) 0.024 2.58(0.84–7.89) 0.095 BMI 29.9 6(2%) 16(5.2%) 4.5(1.33–15.15) 0.015 ** 3.66(0.754–17.775) 0.108 History of alcohol use Yes 2(0.6%) 2(0.6%) 5.84(0.80-42.55) 0.082 2.64(0.147–47.548) 0.510 No 44(14.4%) 257(84.2%) 1 1 1 1 History of hypercholesterolemia Yes 9(2.9%) 16(5.2%) 3.69(1.52–8.96) 0.004 ** 1.056(0.264–4.227) 0.939 No 37(12%) 243(79.6%) 1 1 1 1 History of DM Yes 14(4.5%) 30(9.8%) 3.34(1.60–6.96) 0.001 ** 1.729(0.510–5.860) 0.379 No 32(10.5%) 229(75%) 1 1 1 1 History of hypertension Yes 15(4.9%) 43(14%) 2.43(1.20–4.88) 0.013 ** 1.797(0.554–5.833) 0.329 No 31(10%) 216(70.8%) 1 1 1 1 Previous cardiac catheterization Yes 13(4.2%) 11(3.6%) 8.88(3.67–21.43) 0.000 ** 5.269(1.599–17.363) 0.006 * No 33(10.8%) 248(81%) 1 1 1 1 Size of sheath 4–6 Fr 27(8.8%) 148(48.5%) 1.15(0.60–2.23) 0.659 1.31(0.524–3.275) 0.564 7–8 Fr 17(5.5%) 108(35.4%) 1 1 1 1 9–10 Fr 0 2(0.6%) 0.000 0.999 0.000 0.999 > 10 Fr 2(0.6%) 1(0.3%) 12.7(1.09–147.8) 0.042 ** 15.4(1.098–216.5) 0.042 * Time taken for the procedure > 1 hr 4(1.3%) 35(11.4%) 3.08(0.326–29.22) 0.326 6.50(0.509–83.274) 0.150 30–60 min 41(13.4%) 197(64.5%) 5.61(0.74–42.53) 0.095 ** 7.44(0.77–71.32) 0.082 30 min 1(0.3%) 27(8.8%) 1 1 1 1 Type of anticoagulant Heparin 31(10%) 226(74%) 1 1 1 1 Heparin + Clopidogrel + Asprin 3(0.9%) 3(0.9%) 7.29(1.40-37.72) 0.018 ** 6.80(0.772–59.914) 0.084 Heparin + Clopidogrel 12(3.9%) 30(9.8%) 2.91(1.35–6.28) 0.006 ** 1.899(0.621–5.810) 0.261 Discussion This study assessed the vascular complication and associated factors among patients who underwent cardiac catheterization at Ethiopian cardiac center. The findings revealed that 15.1% of patients developed vascular complications. These rates are higher than those reported in high income countries, where vascular complication rates typically range between 1–5%; studies in the United States and Canada have reported vascular complication rates as low as 1.0-4.5%, depending on the nature of the procedure ( 13 , 9 , 3 ). This variation may be due to differences in procedural techniques, patient comorbidities, or post procedural care quality between high-income and low- to middle-income setting. On the other hand other studies in Greece, Sweden, and Egypt had vascular complication of 60%, 0–36%, and 54% respectively ( 15 , 16 , 1 ). The possible explanation for this variation might be due to differences in patient population differences, sample size and study design. Where a study in Greece, Sweden and Egypt had sample size of 10,450, 4487, and 50 respectively, and employed retrospective and descriptive study designs. Compared to these, the relatively smaller In line with global findings, this study found that female gender was significantly associated with an increased risk of vascular complications. Female patients were 4 times more likely to develop such complications compared to males. This is consistent with findings from Germany and the USA, where female sex was an independent risk factor of vascular complications ( 17 , 18 ). The increased risk among females may be attributed to anatomical differences in which females had tiny vessels, anticoagulant sensitivity females are more sensitive’s and hormonal influences particularly estrogen in females that affect vascular integrity. Additionally, body mass index (BMI) was significantly associated with vascular complications. Patients categorized as overweight (BMI 25-29.9) had 5.3 times higher odds of experiencing complications compared to those with BMI < 18.5. This finding is supported by previous studies from Europe, USA and Egypt that identified higher BMI as a significant predictor of post catheterization complication ( 12 , 8 , 1 ). Excess adipose tissue may hinder vascular access, impair hemostasis, and increase the risk of hematoma formation due to higher venous pressure and altered pharmacokinetics of anticoagulants. The study also identified a history of previous cardiac catheterization as a strong predictor of vascular complications. This aligns with findings from multicenter studies in Europe, which reported previous vascular complications or procedures as significant predictors of recurrent adverse event ( 12 ). Repeated access through the same vascular site may result in fibrosis, vessel trauma, or scarring, which can compromise subsequent procedural safety. A study in Europe emphasized that larger sheath sizes associated with increased risk of vascular complications ( 12 ). Similarly, in this study, patients with larger sheath sizes had a notably higher risk of vascular complication consistent with findings from Cairo University, which reported a significant association between larger sheath sizes and femoral hematoma formation after sheath removal ( 2 ). This trend supports the notion that minimizing sheath size when possible could mitigate complication risks. Limitations One of the main limitations of this study is document review, which may affect the quality of the data, as it relies on how healthcare professionals documented patient information during routine care. Additionally the assessment was limited to immediate or short-term post-procedural complications, so any delayed vascular events may have gone undetected. Conclusion This study identified that 15.1% of patients who underwent cardiac catheterization had vascular complications. The most common major complications were hematoma, hemorrhage, and thromboembolism. Multivariate analysis revealed that female gender, overweight, and a history of prior cardiac catheterization were risk factors for vascular complications. Although some behavioral and medical factors did not reach statistical significance in the final model, their potential role should be considered from other studies. Abbreviations A-Fib Atrial Fibrillation ASD Atrial Septal Defect:AVF:Arterio-venous Fistula BMI – Body Mass Index BVP Balloon Valvuloplasty DM Diabetes Mellitus MI Myocardial Infarction PCI Percutaneous Coronary Intervention PDA Patent Ductus Arteriosus PMBC Percutaneous Mitral Balloon Commissurotomy PTCA Percutaneous Trans-luminal Coronary Angiography Declarations Ethic s Approval and consent to participate Ethical approval was obtained from the Institutional Review Board of department of Nursing, Addis Ababa University (IRC-N AAU) with protocol number 166/22. Permission to access the data was secured from Ethiopian Cardiac Center. The study was conducted using secondary data extracted from patient medical records, and no direct contact with participants occurred. Informed consent was waived by the IRB due to the retrospective nature of the study and the use of anonymized data. Confidentiality was maintained by excluding personal identifiers and coding the data. All data were stored securely and accessed only by the research team. The study adhered to the principles of the Declaration of Helsinki. Consent for publication Not applicable Clinical trial number Not applicable Availability of data and materials The data sets used for this study are available from the corresponding author on reasonable request. Competing interest None of the authors has a financial or other conflict of interest. Funding The authors did not receive any specific funding or grants for this research from public, commercial, or not-for-profit agencies. Author contributions SD writes the back ground, and methods sections and analyzed and interprets the patients’ data, DA help throughout the process of the proposal writing and analysis, preparingthe manuscript. Niguse tadele and Nete towfik was give constructive comments and advising. Acknowledgment First, I would like to thank Addis Ababa University, College of Health Sciences, School of Nursing and Midwifery for giving me a chance to conduct this research and giving me a scholarship to pursue my M.Sc. education. Second, I would like to thank my advisors, Mr. Niguse Tadele (MSc, Asst. Prof) and Sr. Nete Tewfik (BSc, MSc) for their guidance throughout the development of this thesis. Third, I would like to thank Nr. Amero Baymot (MSc) for his support and constructive comments on this thesis development. Last but not least, I also want to thank my friends and data collectors for their support. References Jabr EM, Taha NM, Metwaly EA. 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Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviewers agreed at journal 30 Apr, 2026 Reviewers agreed at journal 23 Apr, 2026 Reviewers invited by journal 21 Apr, 2026 Editor assigned by journal 20 Apr, 2026 Editor invited by journal 31 Mar, 2026 Submission checks completed at journal 30 Mar, 2026 First submitted to journal 30 Mar, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9224661","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":631190889,"identity":"fa835964-45f7-423a-943c-c47e03af8fbb","order_by":0,"name":"Sosina Dejene","email":"","orcid":"","institution":"Addis Ababa University","correspondingAuthor":false,"prefix":"","firstName":"Sosina","middleName":"","lastName":"Dejene","suffix":""},{"id":631190890,"identity":"ef1000bf-c270-4e8f-bd7d-3b3af7daaae2","order_by":1,"name":"Deribew Awoke","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAwUlEQVRIiWNgGAWjYDCCAxBKDsx+QLyWBAZjMDuBFC2JDRCaCMB3vPeZxM8fdunzww4/BNpiJ6fbQECL5JnjZpI9Ccm5G2+nGQC1JBubHSCgxeBGGrMBTwJz7sbZCSAtBxK3EdRy/xmz4Z+E+nTD2ekfiNRyg43xMU/C4QR56RwibZE8k8b4WCbtuOEG6ZyCAwkGRPiF7/gxhoNvbKrl5Wenb/7wocJOjqAWhAvBKg2IVQ4C8g2kqB4Fo2AUjIIRBQBTvEd6rjckGAAAAABJRU5ErkJggg==","orcid":"","institution":"Arba Minch health science college","correspondingAuthor":true,"prefix":"","firstName":"Deribew","middleName":"","lastName":"Awoke","suffix":""},{"id":631190891,"identity":"508d8b38-83d8-4efe-abf6-90cb8081f2df","order_by":2,"name":"Niguse Tadele","email":"","orcid":"","institution":"Addis Ababa University","correspondingAuthor":false,"prefix":"","firstName":"Niguse","middleName":"","lastName":"Tadele","suffix":""},{"id":631190892,"identity":"01742106-8d4a-46bf-abb4-a4033eabbc9c","order_by":3,"name":"Nete Tewfik","email":"","orcid":"","institution":"Addis Ababa University","correspondingAuthor":false,"prefix":"","firstName":"Nete","middleName":"","lastName":"Tewfik","suffix":""}],"badges":[],"createdAt":"2026-03-25 14:54:51","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9224661/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9224661/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":108097666,"identity":"83fa8824-1102-4438-ada6-47b38db1a77e","added_by":"auto","created_at":"2026-04-29 10:15:22","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":26227,"visible":true,"origin":"","legend":"\u003cp\u003evascular complication of patients who underwent cardiac catheterization\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-9224661/v1/1b8c65c9539527e291fce453.png"},{"id":108182820,"identity":"f4528003-50cd-4bb4-91a0-d1119dbb1952","added_by":"auto","created_at":"2026-04-30 08:59:35","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":495909,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9224661/v1/8e955a90-0089-47ff-b122-bbd0f4a4ab8e.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003eAssessment of Vascular Complication and Associated Factors Among Patients who Underwent Cardiac Catheterization, A retrospective study at Ethiopian Cardiac Center, Addis Ababa, Ethiopia, 2025\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003eCardiac catheterization is an invasive procedure used to diagnose and treat heart conditions. It is the primary method for diagnosing and managing coronary artery diseases (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). Over time, the criteria for cardiac catheterization have expanded from primarily low-risk patients to include those with complex coronary diseases and high-risk situations, such as acute coronary syndromes(\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). Its invasive nature can lead to various complications. The most frequent complications are vascular, which can lead to increased discomfort, longer hospital stays, and poorer patient outcomes. Vascular complication refers to problems that arise in the blood vessels (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). To address this, multiple studies have been conducted to help cardiologists identify, report, and monitor these complications, aiming to establish performance standards for catheterization labs(\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). Cardiac catheterization is performed through the radial and femoral artery approach. The radial artery is often linked to vascular complications, but these have less occurrence when compared to the femoral approach(\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). Injuries to the femoral artery are common following diagnostic and therapeutic cardiac catheterizations(\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). Vascular complications have been recognized as significant contributors to post-procedural morbidity. Recent research highlights that bleeding after cardiac catheterization is a notable source of complications that lead mortality(\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). Common major and minor complications associated with femoral artery access include: hematomas, arteriovenous fistulas (AVF), pseudoaneurysms, retroperitoneal hematomas, and external bleeding, femoral artery dissection, loss of pulse to the distal extremity, mycotic aneurysms (major complication) and ecchymosis, mild bleeding and swelling (minor complication)(\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). Large-scale studies of cardiac catheterization have found that the rate of major vascular complications ranges from 0.3% to 1%. Complications related to vascular access occur in 0.8% to 1.8% of diagnostic cardiac catheterizations, and between 1.5% and 9% of cases involving percutaneous coronary interventions (PCI) performed through the trans-femoral approach(\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e) Vascular complications following cardiac catheterization vary based on technological and economic development. High-income countries experience fewer vascular complications compared to countries with middle- and low-income economies. These prevalence have been reported as follows: 1% in the northeastern US, 10.5% in Virginia (USA), 32.4% in Canada, 36% in Sweden, 53.3% in Greece, and 66% in Egypt (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan additionalcitationids=\"CR14 CR15\" citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eDespite advancements in techniques and technologies designed to reduce complications, there remains a significant occurrence of vascular complications after cardiac catheterization(\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). The differences in complication rates among various patient populations indicate that certain risk factors\u0026mdash;such as age, female sex, obesity, smoking, coexisting conditions like hypertension, renal failure, diabetes mellitus, recent myocardial infarction, as well as the use of large sheaths, excessive coagulation, and hemodynamic instability are linked to an increased risk(\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). There is a limited study, even not directly related to the topic the prevalence of vascular complication remained unknown. This finding will contribute to health care providers implement more targeted interventions to prevent these complications, to reduce costs associated with post-cardiac catheterization care, to developing guidelines and protocols for the prevention and management of vascular complications in post-cardiac catheterization patients, help policymakers to standardize care practices and improve overall patient safety. It can also highlight areas for quality improvement in post-cardiac catheterization care, leading to better patient outcomes and higher standards of care.\u003c/p\u003e"},{"header":"Methods and Materials","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\n \u003ch2\u003eStudy design, area and population\u003c/h2\u003e\n \u003cp\u003eA retrospective cross sectional study was conducted from January 20 to February 20, 2025 in Ethiopian cardiac center in Addis Ababa, Ethiopia. All adult patients who underwent cardiac catheterization in Ethiopian cardiac center from January 1, 2020 to December 31, 2024, and with full information/medical records were included except patients who have unclear and unreadable information in the record. The sample size was calculated using a single population proportion formula based on the assumptions of the 95% confidence level, 5% margin of error, and 66% population proportion taken from the study done in Egypt. A total of 305, with a 100% data retrieval rate was consented. Systematic random sampling technique was used to select study subjects from the study population after a sampling frame list of the study population was prepared from the procedure registration book of the study period. To select patients document K interval was calculated and obtained 5 the first document selected by simple random sampling method.\u003c/p\u003e\n\u003c/div\u003e\n\u003ch3\u003eDependent variables\u003c/h3\u003e\n\u003cp\u003eVascular complication following cardiac catheterization\u003c/p\u003e\n\u003ch3\u003eIndependent variables\u003c/h3\u003e\n\u003cp\u003eSocio demographic factor (Age, Gender, Body mass index, Occupation), Medical history (History of cardiovascular disease, History of DM, History of chronic kidney disease, Previous cardiac catheterization), Procedural and behavioral factors (Access site, Duration of the procedure, Use of anticoagulants, Smoking status, Alcohol consumption, Size of sheath, Type of procedure)\u003c/p\u003e\n\u003ch3\u003eData collection tool, procedure and quality control\u003c/h3\u003e\n\u003cp\u003eThe data was gathered from medical records using structured data extraction checklists. Data were collected by using a pre-tested checklist. A pre-test was done on 5% of the study population (15 adult post cardiac catheterization patients) at Tikur Anbessa Specialized Hospital in Addis Ababa, Ethiopia. The result of the pre-test was used to correct some unclear ideas and statements and the data was not incorporated into the main result. The questions addressed were three sections socio demographic characteristics, vascular complication and related risk factors. The data were collected by two trained professional nurses under the supervision of one supervisors and a principal investigator.\u003c/p\u003e\n\u003ch3\u003eData analysis and processing\u003c/h3\u003e\n\u003cp\u003eThe data were cleaned and coded to prepare it for processing and analysis. SPSS version 26 software were employed for this analysis. Descriptive statistics summarized the result in percentages and frequencies. In statistical analysis binary logistic analysis were done. Initially, bi-variable analysis were used to identify candidate significant independent variables that have association with independent and dependent variables. Factors showing an association with a p-value less than 0.25 were selected for multivariable logistic regression analysis to account for confounding variables. The strength of associations among the independent variables in relation to the dependent variable was assessed using adjusted odds ratios (AOR) along with a 95% confidence interval, with p-values below 0.05 deemed statistically significant.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical approval and consent\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical approval was obtained from the Institutional Review Board of department of Nursing, Addis Ababa University (IRC-N AAU) with protocol number 166/22. Permission to access the data was secured from Ethiopian Cardiac Center. The study was conducted using secondary data extracted from patient medical records, and no direct contact with participants occurred. Informed consent was waived by the IRB due to the retrospective nature of the study and the use of anonymized data. Confidentiality was maintained by excluding personal identifiers and coding the data. All data were stored securely and accessed only by the research team. The study adhered to the principles of the Declaration of Helsinki.\u003c/p\u003e\n"},{"header":"Result","content":"\u003ch2\u003eSocio-demographic Characteristics\u003c/h2\u003e\n\u003cp\u003eA total of 305 eligible documents engaged in the study, yielding a response rate of 100% (305/ 305).The study sample included 182 (59.7%) females and 123 (40.3%) males. The mean age of patients was 38\u0026thinsp;\u0026plusmn;\u0026thinsp;17.33 years. Approximately half of the patients were between the ages of 18 and 34 years.\u003c/p\u003e\n\u003cp\u003eIn terms of occupation, 155 (50.8%) patients were not working, while 79 (25.9%) were daily laborers and 71 (23.3%) were office workers. Regarding body mass index (BMI) the mean was 22\u0026thinsp;\u0026plusmn;\u0026thinsp;4.68, 91 (29.8%) patients were underweight, 149 (48.9%) had normal weight, 43 (14.1%) were overweight, and 22 (7.2%) were classified as obese. (Table \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e)\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\u0026nbsp;\u003ctable id=\"Tab1\" border=\"1\"\u003e\n \u003ccaption\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eSocio-demographic characteristics of patients who underwent cardiac catheterization (n\u0026thinsp;=\u0026thinsp;305)\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003ccolgroup cols=\"4\"\u003e\u003c/colgroup\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eFrequency\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003ePercent\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003eGender\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e182\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e59.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e123\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e40.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"4\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge Group interval\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e18\u0026ndash;34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e163\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e53.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e35\u0026ndash;50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e22.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e51\u0026ndash;66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e16.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e67\u0026ndash;82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e7.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003e\u003cstrong\u003eOccupation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDaily laborer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e25.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNot working\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e155\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e50.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOffice working\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e23.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"4\"\u003e\n \u003cp\u003e\u003cstrong\u003eBMI Group\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;18.5 (underweight)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e29.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e18.5\u0026ndash;24.9(normal weight)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e149\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e48.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e25\u0026ndash;29.9(over weight)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e14.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026gt;\u0026thinsp;29.9 (obesity)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e7.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003ch3\u003eInformation on vascular complication\u003c/h3\u003e\n\u003cp\u003eOut of the 305 patients included in the study, 46 (15.1%) experienced vascular complications following the procedure, while the majority, 259 (84.9%) patients did not report any such complications (Fig. \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e). Regarding the minor types of vascular complications, 7 (2.3%) patients experienced ecchymosis and 11 (3.6%) had mild bleeding. In terms of major vascular complications, 14 (4.6%) developed hematomas, 3 (1.0%) had thromboembolism, and 11 (3.6%) suffered from hemorrhage. (Table \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e)\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\u0026nbsp;\u003ctable id=\"Tab2\" border=\"1\"\u003e\n \u003ccaption\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eVascular Complications faced among patients who underwent cardiac catheterization (n\u0026thinsp;=\u0026thinsp;305)\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003ccolgroup cols=\"4\"\u003e\u003c/colgroup\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eComplication Type\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eSubcategory\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eFrequency\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003ePercent\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003e\u003cstrong\u003eMinor Complications\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e287\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e94.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eEcchymosis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMild bleeding\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e3.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"4\"\u003e\n \u003cp\u003e\u003cstrong\u003eMajor Complications\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e277\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e90.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHematoma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e4.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eThromboembolism\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHemorrhage\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e3.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003ch2\u003eMedical factors of patients\u003c/h2\u003e\n\u003cp\u003eAmong the patients document, several had pre-existing medical conditions. The most frequently reported condition was coronary artery disease, present in 61 (27.0%) individuals, followed by hypertension in 58 (25.7%) individuals, and diabetes mellitus in 44 (19.5%) individuals. A history of hypercholesterolemia was reported by 25 (11.1%) patients and atrial fibrillation by 22 (9.7%). Fewer patients reported a history of myocardial infarction 9 individuals (4.0%) and chronic kidney disease 7 individuals (3.1%). These figures represent the number of respondents who indicated \u0026ldquo;yes\u0026rdquo; to each condition, with percentages calculated from the total valid responses. Notably, due to multiple conditions being reported by some patients, the total percentage exceeds 100%. (Table \u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e)\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\u0026nbsp;\u003ctable id=\"Tab3\" border=\"1\"\u003e\n \u003ccaption\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eMedical history of patients who underwent cardiac catheterization (n\u0026thinsp;=\u0026thinsp;305)\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003ccolgroup cols=\"4\"\u003e\u003c/colgroup\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eMedical Condition\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eFrequency (N)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003ePercent (%)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003ePercent of Cases (%)\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHistory of Coronary Artery Disease (CAD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e27.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e52.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHistory of Hypertension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e25.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e49.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHistory of Diabetes Mellitus (DM)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e19.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e37.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHistory of Hypercholesterolemia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e11.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e21.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHistory of Atrial Fibrillation (A-fib)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e9.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e18.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHistory of Myocardial Infarction (MI)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e4.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e7.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHistory of Chronic Kidney Disease\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e3.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e6.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e226\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e100.0%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e193.2%\u003c/strong\u003e*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003ch2\u003eProcedural and behavioral factors of patients\u003c/h2\u003e\n\u003cul\u003e\n \u003cli\u003e\n \u003cp\u003eAmong the 305 patient documents, only 6 (2.0%) had a history of smoking, and 4 (1.3%) reported alcohol consumption, indicating that such lifestyle risk factors were rare in the study population.\u003c/p\u003e\n \u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eA previous cardiac catheterization was 24 (7.9%) patients, while the majority, 281(92.1%), and were undergoing the procedure for the first time. Regarding the vascular access site, the femoral artery was used in 285 (93.4%) patients, whereas the radial artery was accessed in 20 (6.6%) patients\u003c/p\u003e\n\u003cp\u003eThe purpose of catheterization was predominantly interventional (81.3%), with diagnostic procedures accounting for the remaining 18.7%. The most common procedure performed was percutaneous trans-venous mitral commissurotomy/percutaneous mitral balloon commissurotomy (PTMC/PMBC), done in 158 (51.8%) cases, followed by coronary angiography (57, 18.7%) and PCI (33, 10.8%). Less frequent procedures included BPV (25, 8.2%), ASD device closure (19, 6.2%), PDA device closure (11, 3.6%), and coarcoplasty (2, 0.7%).\u003c/p\u003e\n\u003cp\u003eIn terms of sheath size, 57.4% of procedures used 4\u0026ndash;6 Fr sheaths, 41.0% used 7\u0026ndash;8 Fr, and a small fraction used 9\u0026ndash;10 Fr (0.7%) or \u0026gt;\u0026thinsp;10 Fr (1.0%). Most procedures (78.0%) lasted between 30 minutes and 1 hour, while 12.8% exceeded 1 hour, and 9.2% were completed within 30 minutes.\u003c/p\u003e\n\u003cp\u003eNearly all procedures (99.0%) involved a single femoral or radial puncture, with multiple punctures being extremely rare. Regarding anticoagulation, Heparin alone was used in the vast majority of cases 257(84.2%), followed by combinations such as Heparin with Clopidogrel 42(13.8%) and Heparin with Clopidogrel and Aspirin 6(2%). (Table \u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e)\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\u0026nbsp;\u003ctable id=\"Tab4\" border=\"1\"\u003e\n \u003ccaption\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eSummary of Lifestyle, Catheterization, and Procedural Characteristics of patients underwent cardiac catheterization (n\u0026thinsp;=\u0026thinsp;305)\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003ccolgroup cols=\"4\"\u003e\u003c/colgroup\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eCategory\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eSubcategory\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eFrequency\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003ePercent\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003eSmoking\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e299\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e98.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003eAlcohol Use\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e301\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e98.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003ePrevious Catheterization\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e281\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e92.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e7.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003eAccess Site\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFemoral\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e285\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e93.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRadial\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e6.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003ePurpose of Catheterization\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eInterventional\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e248\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e81.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDiagnostic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e18.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"7\"\u003e\n \u003cp\u003e\u003cstrong\u003eType of Procedure\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePTMC/PMBC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e158\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e51.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCoronary Angiography\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e18.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePCI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e10.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBVP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e8.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eASD D/C\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e6.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePDA D/C\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e3.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCoarcoplasty\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"4\"\u003e\n \u003cp\u003e\u003cstrong\u003eSheath Size\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4\u0026ndash;6 Fr\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e175\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e57.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7\u0026ndash;8 Fr\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e125\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e41.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026gt;\u0026thinsp;10 Fr\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9\u0026ndash;10 Fr\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003e\u003cstrong\u003eProcedure Duration\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e30\u0026ndash;60 minutes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e238\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e78.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026gt;\u0026thinsp;1 hour\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e12.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e30 minutes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e9.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003ePuncture Frequency\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSingle femoral/radial puncture\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e303\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e99.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMultiple femoral/radial puncture\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003e\u003cstrong\u003eAnticoagulant Used\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHeparin only\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e257\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e84.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHeparin\u0026thinsp;+\u0026thinsp;Clopidogrel\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e13.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHeparin\u0026thinsp;+\u0026thinsp;Clopidogrel\u0026thinsp;+\u0026thinsp;Aspirin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003ch2\u003eFactors associated with vascular complication among patients underwent cardiac catheterization\u003c/h2\u003e\n\u003cp\u003eThe following socio-demographic, medical, procedural and behavioral factors were analyzed. Among these; gender, age, occupation, BMI, history of alcohol use, history of hypercholesterolemia, history of DM, history of hypertension, previous cardiac catheterization, size of sheath, time taken for the procedure, sheath removal time and type of anticoagulant used were significant at P\u0026thinsp;\u0026lt;\u0026thinsp;0.25 by bi-variable analysis. All these factors were entered to multivariable analysis by controlling the effect of confounding factors gender, BMI and previous cardiac catheterization were found to have significantly high odds of vascular complication at P\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e\n\u003cp\u003eFemale patients were 4 times more likely to experience vascular complications compared to males (AOR\u0026thinsp;=\u0026thinsp;4.07, 95% CI: 1.50\u0026ndash;11.02, P\u0026thinsp;=\u0026thinsp;0.006). Patients with BMI of25\u0026ndash;29.9 (overweight) had 5.3 times higher odds of developing vascular complications compared to those with a BMI of \u0026lt;\u0026thinsp;18.5 (AOR\u0026thinsp;=\u0026thinsp;5.31, 95% CI: 1.38\u0026ndash;20.32, P\u0026thinsp;=\u0026thinsp;0.015). Additionally, patients with a previous cardiac catheterization were nearly 5.2 times more likely to experience vascular complications than those without such a history (AOR\u0026thinsp;=\u0026thinsp;5.26, 95% CI: 1.59\u0026ndash;17.36, P\u0026thinsp;=\u0026thinsp;0.006). (Table \u003cspan class=\"InternalRef\"\u003e5\u003c/span\u003e)\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n \u003cdiv align=\"left\" class=\"colspec\"\u003e\u003cbr\u003e\u003c/div\u003e\u0026nbsp;\u003ctable id=\"Tab5\" border=\"1\" class=\"fr-table-selection-hover\"\u003e\n \u003ccaption\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eBi-variable and multivariable analysis of factors associated with vascular complication in patients who underwent cardiac catheterization (n\u0026thinsp;=\u0026thinsp;305)\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003ccolgroup cols=\"8\"\u003e\u003c/colgroup\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eVariable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eCategory\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eVascular complication\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eCOR (95% CI)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eP-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eAOR(95% CI)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eP-Value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eno\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e13(4.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e110(36%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e33(10.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e149(49%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.87(0.94\u0026ndash;3.72)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.073\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4.07(1.503\u0026ndash;11.024)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.006\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"4\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e18\u0026ndash;34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e18(5.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e145(47.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e35\u0026ndash;50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12(3.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e57(18.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.69(0.76\u0026ndash;3.74)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.191\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.227(0.397\u0026ndash;3.792)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.723\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e51\u0026ndash;66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12(3.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e37(12%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.6(1.15\u0026ndash;5.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.021\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.445(0.297\u0026ndash;7.03)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.648\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e67\u0026ndash;82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4(1.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e20(6.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.6(0.49\u0026ndash;5.24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.428\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.183(0.019\u0026ndash;1.805)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.146\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003eOccupation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDaily laborer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7(2.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e72(23.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNot working\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e23(7.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e132(43.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.79(0.73\u0026ndash;4.37)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.201\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.72(0.44\u0026ndash;6.707)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.433\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOffice working\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e16(5.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e55(18%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.99(1.15\u0026ndash;7.77)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.024\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.58(0.84\u0026ndash;7.89)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.095\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"4\"\u003e\n \u003cp\u003eBMI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;18.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7(2.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e84(27.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e18.5\u0026ndash;24.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e15(4.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e134(43.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.34(0.52\u0026ndash;3.43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.537\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.233(0.408\u0026ndash;3.725)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.710\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e25-29.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e18(5.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e25(8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8.64(3.24\u0026ndash;23.03)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.000\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.31(1.388\u0026ndash;20.329)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.015\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026gt;\u0026thinsp;29.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6(2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e16(5.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4.5(1.33\u0026ndash;15.15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.015\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.66(0.754\u0026ndash;17.775)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.108\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eHistory of alcohol use\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2(0.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2(0.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.84(0.80-42.55)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.082\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.64(0.147\u0026ndash;47.548)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.510\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e44(14.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e257(84.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eHistory of hypercholesterolemia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9(2.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e16(5.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.69(1.52\u0026ndash;8.96)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.004\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.056(0.264\u0026ndash;4.227)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.939\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e37(12%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e243(79.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eHistory of DM\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e14(4.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e30(9.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.34(1.60\u0026ndash;6.96)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.729(0.510\u0026ndash;5.860)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.379\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e32(10.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e229(75%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eHistory of hypertension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e15(4.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e43(14%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.43(1.20\u0026ndash;4.88)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.013\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.797(0.554\u0026ndash;5.833)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.329\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e31(10%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e216(70.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003ePrevious cardiac catheterization\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e13(4.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e11(3.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8.88(3.67\u0026ndash;21.43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.000\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.269(1.599\u0026ndash;17.363)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.006\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e33(10.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e248(81%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"4\"\u003e\n \u003cp\u003eSize of sheath\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4\u0026ndash;6 Fr\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e27(8.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e148(48.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.15(0.60\u0026ndash;2.23)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.659\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.31(0.524\u0026ndash;3.275)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.564\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7\u0026ndash;8 Fr\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e17(5.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e108(35.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9\u0026ndash;10 Fr\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2(0.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.999\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.999\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026gt;\u0026thinsp;10 Fr\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2(0.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1(0.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12.7(1.09\u0026ndash;147.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.042\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e15.4(1.098\u0026ndash;216.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.042\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003eTime taken for the procedure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026gt;\u0026thinsp;1 hr\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4(1.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e35(11.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.08(0.326\u0026ndash;29.22)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.326\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6.50(0.509\u0026ndash;83.274)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.150\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e30\u0026ndash;60 min\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e41(13.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e197(64.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.61(0.74\u0026ndash;42.53)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.095\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7.44(0.77\u0026ndash;71.32)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.082\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e30 min\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1(0.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e27(8.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003eType of anticoagulant\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHeparin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e31(10%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e226(74%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHeparin\u0026thinsp;+\u0026thinsp;Clopidogrel\u0026thinsp;+\u0026thinsp;Asprin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3(0.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3(0.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7.29(1.40-37.72)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.018\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6.80(0.772\u0026ndash;59.914)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.084\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHeparin\u0026thinsp;+\u0026thinsp;Clopidogrel\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12(3.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e30(9.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.91(1.35\u0026ndash;6.28)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.006\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.899(0.621\u0026ndash;5.810)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.261\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study assessed the vascular complication and associated factors among patients who underwent cardiac catheterization at Ethiopian cardiac center. The findings revealed that 15.1% of patients developed vascular complications. These rates are higher than those reported in high income countries, where vascular complication rates typically range between 1\u0026ndash;5%; studies in the United States and Canada have reported vascular complication rates as low as 1.0-4.5%, depending on the nature of the procedure (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). This variation may be due to differences in procedural techniques, patient comorbidities, or post procedural care quality between high-income and low- to middle-income setting.\u003c/p\u003e \u003cp\u003eOn the other hand other studies in Greece, Sweden, and Egypt had vascular complication of 60%, 0\u0026ndash;36%, and 54% respectively (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). The possible explanation for this variation might be due to differences in patient population differences, sample size and study design. Where a study in Greece, Sweden and Egypt had sample size of 10,450, 4487, and 50 respectively, and employed retrospective and descriptive study designs. Compared to these, the relatively smaller\u003c/p\u003e \u003cp\u003eIn line with global findings, this study found that female gender was significantly associated with an increased risk of vascular complications. Female patients were 4 times more likely to develop such complications compared to males. This is consistent with findings from Germany and the USA, where female sex was an independent risk factor of vascular complications (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). The increased risk among females may be attributed to anatomical differences in which females had tiny vessels, anticoagulant sensitivity females are more sensitive\u0026rsquo;s and hormonal influences particularly estrogen in females that affect vascular integrity.\u003c/p\u003e \u003cp\u003eAdditionally, body mass index (BMI) was significantly associated with vascular complications. Patients categorized as overweight (BMI 25-29.9) had 5.3 times higher odds of experiencing complications compared to those with BMI\u0026thinsp;\u0026lt;\u0026thinsp;18.5. This finding is supported by previous studies from Europe, USA and Egypt that identified higher BMI as a significant predictor of post catheterization complication (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). Excess adipose tissue may hinder vascular access, impair hemostasis, and increase the risk of hematoma formation due to higher venous pressure and altered pharmacokinetics of anticoagulants.\u003c/p\u003e \u003cp\u003eThe study also identified a history of previous cardiac catheterization as a strong predictor of vascular complications. This aligns with findings from multicenter studies in Europe, which reported previous vascular complications or procedures as significant predictors of recurrent adverse event (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). Repeated access through the same vascular site may result in fibrosis, vessel trauma, or scarring, which can compromise subsequent procedural safety.\u003c/p\u003e \u003cp\u003eA study in Europe emphasized that larger sheath sizes associated with increased risk of vascular complications (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). Similarly, in this study, patients with larger sheath sizes had a notably higher risk of vascular complication consistent with findings from Cairo University, which reported a significant association between larger sheath sizes and femoral hematoma formation after sheath removal (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). This trend supports the notion that minimizing sheath size when possible could mitigate complication risks.\u003c/p\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eLimitations\u003c/h2\u003e \u003cp\u003eOne of the main limitations of this study is document review, which may affect the quality of the data, as it relies on how healthcare professionals documented patient information during routine care. Additionally the assessment was limited to immediate or short-term post-procedural complications, so any delayed vascular events may have gone undetected.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study identified that 15.1% of patients who underwent cardiac catheterization had vascular complications. The most common major complications were hematoma, hemorrhage, and thromboembolism. Multivariate analysis revealed that female gender, overweight, and a history of prior cardiac catheterization were risk factors for vascular complications. Although some behavioral and medical factors did not reach statistical significance in the final model, their potential role should be considered from other studies.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eA-Fib\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eAtrial Fibrillation\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eASD\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eAtrial Septal Defect:AVF:Arterio-venous Fistula\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eBMI \u0026ndash; Body Mass Index\u003c/div\u003e \u003cdiv class=\"Description\"\u003e\u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eBVP\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eBalloon Valvuloplasty\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eDM\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eDiabetes Mellitus\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eMI\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eMyocardial Infarction\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003ePCI\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ePercutaneous Coronary Intervention\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003ePDA\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ePatent Ductus Arteriosus\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003ePMBC\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ePercutaneous Mitral Balloon Commissurotomy\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003ePTCA\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ePercutaneous Trans-luminal Coronary Angiography\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthic\u003c/strong\u003e\u003cstrong\u003es Approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical approval was obtained from the Institutional Review Board of department of Nursing, Addis Ababa University (IRC-N AAU) with protocol number 166/22. Permission to access the data was secured from Ethiopian Cardiac Center. The study was conducted using secondary data extracted from patient medical records, and no direct contact with participants occurred. Informed consent was waived by the IRB due to the retrospective nature of the study and the use of anonymized data. Confidentiality was maintained by excluding personal identifiers and coding the data. All data were stored securely and accessed only by the research team. The study adhered to the principles of the Declaration of Helsinki.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical trial number\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data sets used for this study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interest\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNone of the authors has a financial or other conflict of interest.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors did not receive any specific funding or grants for this research from public, commercial, or not-for-profit agencies.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contributions\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSD writes the back ground, and methods sections and analyzed and interprets the patients\u0026rsquo; data, DA help throughout the process of the proposal writing and analysis, preparingthe manuscript. Niguse tadele and Nete towfik was give constructive comments and advising.\u0026nbsp;\u003c/p\u003e\n\u003cp id=\"_Toc199147346\"\u003e\u003cstrong\u003eAcknowledgment\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFirst, I would like to thank Addis Ababa University, College of Health Sciences, School of Nursing and Midwifery for giving me a chance to conduct this research and giving me a scholarship to pursue my M.Sc. education.\u003c/p\u003e\n\u003cp\u003eSecond, I would like to thank my advisors, Mr. Niguse Tadele (MSc, Asst. Prof)\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eand Sr. Nete Tewfik (BSc, MSc)\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003efor their guidance throughout the development of this thesis.\u003c/p\u003e\n\u003cp\u003eThird, I would like to thank Nr. Amero Baymot (MSc) for his support and constructive comments on this thesis development. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eLast but not least, I also want to thank my friends and data collectors for their support.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eJabr EM, Taha NM, Metwaly EA. Vascular Complications and Risk factors regarding Patient Undergoing Cardiac Catheterization. Journal of Cardiovascular Disease Research. 2021;12(05).\u003c/li\u003e\n \u003cli\u003eEbeed MES, Khalil NS, Ismaeel MS. Vascular complications and risk factors among patients undergoing cardiac catheterization. Egyptian Nursing Journal. 2017;14(3):259-68.\u003c/li\u003e\n \u003cli\u003eChandrasekar B, Doucet S, Bilodeau L, Crepeau J, deGuise P, Gregoire J, et al. Complications of cardiac catheterization in the current era: a single‐center experience. Catheterization and cardiovascular interventions. 2001;52(3):289-95.\u003c/li\u003e\n \u003cli\u003eWyman RM, Safian RD, Portway V, Skillman JJ, Mckay RG, Baim DS. Current complications of diagnostic and therapeutic cardiac catheterization. Journal of the American College of Cardiology. 1988;12(6):1400-6.\u003c/li\u003e\n \u003cli\u003eSanmart\u0026iacute;n M, Cuevas D, Goicolea J, Ruiz-Salmer\u0026oacute;n R, G\u0026oacute;mez M, Argibay V. Vascular complications associated with radial artery access for cardiac catheterization. Revista Espa\u0026ntilde;ola de Cardiolog\u0026iacute;a (English Edition). 2004;57(6):581-4.\u003c/li\u003e\n \u003cli\u003eMcCann RL, Schwartz LB, Pieper KS. Vascular complications of cardiac catheterization. Journal of vascular surgery. 1991;14(3):375-81.\u003c/li\u003e\n \u003cli\u003eApplegate RJ, Sacrinty MT, Kutcher MA, Kahl FR, Gandhi SK, Santos RM, et al. Trends in vascular complications after diagnostic cardiac catheterization and percutaneous coronary intervention via the femoral artery, 1998 to 2007. JACC: Cardiovascular Interventions. 2008;1(3):317-26.\u003c/li\u003e\n \u003cli\u003eDumont CJ, Keeling AW, Bourguignon C, Sarembock IJ, Turner M. Predictors of vascular complications post diagnostic cardiac catheterization and percutaneous coronary interventions. Dimensions of Critical Care Nursing. 2006;25(3):137-42.\u003c/li\u003e\n \u003cli\u003eRicci MA, Trevisani GT, Pilcher DB. Vascular complications of cardiac catheterization. The American journal of surgery. 1994;167(4):375-8.\u003c/li\u003e\n \u003cli\u003eArora N, Matheny ME, Sepke C, Resnic FS. A propensity analysis of the risk of vascular complications after cardiac catheterization procedures with the use of vascular closure devices. American heart journal. 2007;153(4):606-11.\u003c/li\u003e\n \u003cli\u003eSlicker K, Lane WG, Oyetayo OO, Copeland LA, Stock EM, Michel JB, et al. Daily cardiac catheterization procedural volume and complications at an academic medical center. Cardiovascular diagnosis and therapy. 2016;6(5):446.\u003c/li\u003e\n \u003cli\u003ePaganin A, Beghetto MG, Hirakata VN, Hil\u0026aacute;rio TdS, Matte R, Sauer JM, et al. A Vascular Complications Risk (VASCOR) score for patients undergoing invasive cardiac procedures in the catheterization laboratory setting: A prospective cohort study. European Journal of Cardiovascular Nursing. 2017;16(5):409-17.\u003c/li\u003e\n \u003cli\u003eSharma PS, Padala SK, Gunda S, Koneru JN, Ellenbogen KA. Vascular complications during catheter ablation of cardiac arrhythmias: a comparison between vascular ultrasound guided access and conventional vascular access. Journal of\u003c/li\u003e\n \u003cli\u003eMehta R, Lee KJ, Chaturvedi R, Benson L. Complications of pediatric cardiac catheterization: a review in the current era. Catheterization and Cardiovascular Interventions. 2008;72(2):278-85cardiovascular electrophysiology. 2016;27(10):1160-6.\u003c/li\u003e\n \u003cli\u003eFilis K, Arhontovasilis F, Theodorou D, Albanopoulos K, Lagoudianakis E, Manouras A, et al. Management of early and late detected vascular complications following femoral arterial puncture for cardiac catheterization. Hellenic J Cardiol. 2007;48(3):134-42.\u003c/li\u003e\n \u003cli\u003eFransson S-G, Nylander E. Vascular injury following cardiac catheterization, coronary angiography, and coronary angioplasty. European heart journal. 1994;15(2):232-5.\u003c/li\u003e\n \u003cli\u003eOhlow M-A, Secknus M-A, von Korn H, Neumeister A, Wagner A, Yu J, et al. Incidence and outcome of femoral vascular complications among 18,165 patients undergoing cardiac catheterisation. International journal of cardiology. 2009;135(1):66-71.\u003c/li\u003e\n \u003cli\u003eTavris DR, Gallauresi BA, Dey S, Brindis R, Mitchel K. Risk of local adverse events by gender following cardiac catheterization. Pharmacoepidemiology and drug safety. 2007;16(2):125-31.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-cardiovascular-disorders","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bcar","sideBox":"Learn more about [BMC Cardiovascular Disorders](http://bmccardiovascdisord.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bcar/default.aspx","title":"BMC Cardiovascular Disorders","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Vascular complication and Cardiac catheterization","lastPublishedDoi":"10.21203/rs.3.rs-9224661/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9224661/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground: \u003c/strong\u003eCardiac catheterization is an invasive procedure performed for diagnosing and treating heart conditions. Its invasive nature can lead to various complications. Vascular complications have been recognized as significant contributors to post-procedural morbidity. They also contribute to increased patient discomfort, prolonged hospital stays, higher treatment costs, and negative patient outcomes. Several studies in other setting have shown that the rate of major vascular complications ranges from 0.3% to 1%. However, their prevalence in Ethiopia remains unknown.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eObjective\u003c/strong\u003e: This study aims to determine the prevalence of vascular complications and identify associated risk factors among patients who underwent cardiac catheterization in Ethiopian Cardiac Center, Addis Ababa, Ethiopia, 2025.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods: \u003c/strong\u003eA document review was conducted from January 1, 2020, to December 31, 2024, at the Ethiopian Cardiac Center. A total of 305 patient records were selected using systematic random sampling. Data were collected through structured checklists and analyzed using SPSS version 26. Binary logistic regression analyses were performed to identify factors associated with vascular complications. Adjusted odds ratios (AORs) with 95% confidence intervals (CI) and p-values \u0026lt; 0.05 were considered statistically significant.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003eThe prevalence of vascular complications was 15.1%. The most common complications included hematoma (4.6%), hemorrhage (3.6%), and thromboembolism (1.0%). In Multivariable regression, patients who are females, overweight, and had previous catheterization (AOR = 4.07, 95% CI: 1.50–11.02, P = 0.006), underweight BMI (AOR = 5.31; 95% CI: 1.38–20.32; \u003cem\u003ep\u003c/em\u003e = 0.015), and no previous catheterization (AOR = 5.26; 95% CI: 1.59–17.36; \u003cem\u003ep\u003c/em\u003e= 0.006) were the significant variables.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion: \u003c/strong\u003ethe study shows moderate prevalence of vascular complication and also the risk of complications was significantly higher in female patients, those who were overweight, and those with aprevious catheterization.\u003c/p\u003e","manuscriptTitle":"Assessment of Vascular Complication and Associated Factors Among Patients who Underwent Cardiac Catheterization, A retrospective study at Ethiopian Cardiac Center, Addis Ababa, Ethiopia, 2025","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-04-29 10:15:18","doi":"10.21203/rs.3.rs-9224661/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewerAgreed","content":"252240875447513668822603332197470958459","date":"2026-04-30T16:07:37+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"113918763185980474098426892456042865938","date":"2026-04-23T20:13:18+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-04-21T09:42:50+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-04-20T07:53:29+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-03-31T17:09:22+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-03-30T15:57:35+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Cardiovascular Disorders","date":"2026-03-30T13:03:24+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-cardiovascular-disorders","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bcar","sideBox":"Learn more about [BMC Cardiovascular Disorders](http://bmccardiovascdisord.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bcar/default.aspx","title":"BMC Cardiovascular Disorders","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"7a13ba0d-d844-46af-bf41-b52056b2cbb1","owner":[],"postedDate":"April 29th, 2026","published":true,"recentEditorialEvents":[{"type":"reviewerAgreed","content":"252240875447513668822603332197470958459","date":"2026-04-30T16:07:37+00:00","index":61,"fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-04-29T10:15:19+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-29 10:15:18","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9224661","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9224661","identity":"rs-9224661","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}