Acute perioperative complications after arterial and venous femoral access in major vascular and cardiac procedures: Ischemic or hemorrhagic patterns and how to solve them

A direct percutaneous arterial and venous approach to the common femoral vessel has become the first option in most large-bore percutaneous vascular and cardiac procedures, making the issue of access site–related complications (ASCs) a pressing clinical concern. ASCs represent a potentially limb-threating and/or life-threatening scenario that alters the clinical success of the procedure and contributes to increased length of stay and resource utilization. Preoperative assessment of risk factors for ASCs should be well known before planning an endovascular percutaneous procedure and early diagnosis is necessary for prompt treatment. Several percutaneous and surgical approaches have been reported in case of ASCs, according to the different etiologies of these complications. The aim of this review was to report the incidence of ASCs in vascular and cardiac large-bore procedures, diagnosis, and available treatments according to the latest available literature.