Introduction: Groin hematoma is a well-recognized and common complication after percutaneous coronary invervention (PCI) with trans-femoral approach (TFA). However, understanding of groin hematoma is lacked in Thailand. 

Objective: To study the incidence and factors associated with groin hematoma after PCI with TFA in recent practices among Thai PCI centers.

Methods: Patients who were consecutively recruited into Thai PCI registry and had undergone PCI with TFA were included in the analysis. Various clinical and procedural variables were collected. Groin hematoma was defined as hematoma >5 cm. Univariate and multivariate logistic regression were performed. 

Results: Of 11,253 overall patients, 161 patients (1.43%) developed groin hematoma. Incidence of groin hematoma was slightly higher in patients with acute coronary syndrome (1.62%) compared with patients with stable coronary artery disease (1.21%). From statistical and clinical model multivariate analysis, older age (Odds ratio (OR) 1.02, p=0.001, and OR 1.03, p=0.001), prolonged fluoroscopic time (OR 1.006, p=0.014, and OR 1.006, p=0.013), emergency or urgent PCI (OR 1.56, p= 0.006, and OR 1.53, p=0.010), and more than one puncture (OR 2.89, p<0.001, and OR 2.84, p<0.001) were found to be significantly associated with groin hematoma, respectively. Closure device use was also significantly associated with groin hematoma from statistical model multivariate analysis (OR 1.66, p=0.038).

Conclusions: In a large contemporary patient registry, incidence of groin hematoma after PCI with TFA was low. Most of predisposing factors for groin hematoma remained the same as traditional knowledges, except prolonged fluoroscopic time which was newly identified.

Dr. Chamnian Pattanajak is affiliated with the Queen Sirikit Heart Center of the Northeast, Khon Kaen University, Khon Kaen, Thailand. His research and academic collaborations extend across several leading Thai institutions, including the Faculty of Nursing, Khon Kaen University, and the Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University. He is also associated with the Department of Medicine, Faculty of Medicine, Khon Kaen University. Dr. Pattanajak’s work focuses on cardiovascular medicine and clinical research, contributing to advancements in patient care and medical education in Thailand.