Construction of a nomogram prediction model for the complications of iliofemoral vascular intervention access

Objective: To identify the risk factors for the complications of iliofemoral vascular intervention access and establish a nomogram prediction model for their occurrence. Methods: P atients undergoing endovascular intervention via iliofemoral artery access between January 2020 and April 2025 were enrolled in the study. Related clinical data were retrospectively collected and analyzed. Patients were divided into complication (n = 19) and non-complication (n = 488) groups based on the occurrence of postoperative complications associated with iliofemoral puncture site. The general cohort characteristics were compared between the two groups, and the risk factors for the postoperative complications were identified based on univariate and multivariate logistic regression analyses. A nomogram prediction model was constructed and its performance was evaluated using the area under the receiver operating characteristic (ROC) curve, the Hosmer-Lemeshow test, calibration curve, and decision curve analyses. Results: Platelet count, history of diabetes, vascular calcification, and positional relationship between the puncture point and the femoral head were identified to be the risk factors for the postoperative complications of iliofemoral vascular access. The nomogram model incorporating these factors demonstrated strong performance, with an area under the ROC curve of 0.924 (95% confidence interval: 0.839–1.000), sensitivity of 81.80%, specificity of 95.20%, and overall accuracy of 94.70%.The Hosmer-Lemeshow test yielded χ² = 12.535 and P = 0.8184, indicating a good model fit. Calibration curves showed strong agreement between the nomogram predictions and observed outcomes. Both the ROC and decision curve analysis confirmed the nomogram's robust predictive performance. Conclusions: Platelet count, history of diabetes, vascular calcification, and positional relationship between the puncture point and the femoral head are independent risk factors for the complications of iliofemoral vascular access. The nomogram model established based on these indicators demonstrated a high accuracy in predicting the risk of complications.