SUMMARYDeposition of thrombotic material on catheters was observed following more than 50% of 93 diagnostic catheterizations. The incidence of deposition of thrombotic material on catheters remaining in the body for more than 1 day was 100%.Polyethylene and siliconized polyurethane catheters were less thrombogenic than Teflon end-occluded catheters.A definite time relationship between the thrombus formation and the duration of the catheterization procedure was noted.The growth of thrombi on the outside of catheters does not appear to be linear since catheters can remain in place for 10 days or more.Postcatheterization thrombosis is believed to be due to thrombi stripped from the catheter by the arterial wall. The thrombus which originally encases the catheter will pile up at the puncture site as the catheter is withdrawn. Received December 5, 1969; revision accepted for publication January 20, 1970. Circulation, Volume XLI, May 1970 Seldinger technic catheters, thrombi were noted about the catheters in 40%4 to 91%.5 The site from which the catheter was removed was described as a "fibrin channel' and a "cannulated thrombus." Jacobsson and co-workers6 demonstrated similar thrombotic encasement of the catheter in the arteries of dogs.Clinical signs of thrombotic vascular occlusion are much less common. In a survery of 6,160 cardiac catheterizations, clinical arterial thrombosis was diagnosed in 0.5%.7 By oscillographic monitoring of calf pulsations, Jacobsson and associates8 identified arterial occlusion in 1.4% of patients undergoing femoral artery catheterizations. With routine angiograms made prior to withdrawal of the catheter, Siegelman and associates' found surgical thrombectomy indicated following 2.3% of arteriograms.It is the purpose of this study to determine (1) the incidence of thrombus formation on catheters in clinical practice; (2) the relation of thrombus formation to the duration of the catheterization procedure; (3) the throm-833 by guest on

The results of banding of the pulmonary artery in 111 children with cardiac malformations associated with excessive pulmonary blood flow are presented. Thirty-three of these children died, eleven either of late band complications or after a corrective operation. Patients with ventricular septal defect represent the largest group of malformation among the 111 patients.The overall mortality for banding in patients with isolated ventricular septal defect is 10%, as compared to 36% in patients with ventricular septal defect complicated by an associated lesion. In all infants with ventricular septal defect banded under age 3 months the mortality is 59%, as compared to a mortality of 21% in those banded after age 3 months and only 7% if banded after age 1 year. The overall mortality figures for pulmonary arterial banding have not changed appreciably since 1966; future improvement in banding mortality will depend on improved postoperative management of these infants.Serial hemodynamic studies in patients banded under the age of 2 years have shown a fall in the pulmonary resistance toward normal, with none showing a progression of pulmonary vascular disease. In several patients thickening of the pulmonary valve occurred as a complication of banding.

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