Angiography of the Femoral Artery following Percutaneous Catheterization in Infants and Children

Abstract

Iliac and femoral arteries previously exposed to percutaneous catheterization were examined by angiography in conjunction with re-catheterization in 44 infants and children, most of them with heart disease. Frequency and extension of thrombotic changes were analysed, as well as the relationship between occurrence of thrombotic complications and age, haematocrit value, catheterization time, and tendency to arterial spasm. Only age and arterial spasm were significant for the occurrence of thrombotic complications. Injury of the intima was considered to be the primary cause of these complications.

A review of vascular surgery in the pediatric population

“…However, arterial catheterization in smaller children poses a higher risk of iatrogenic vascular injury [20]. Age has been shown to significantly correlate with development of thrombosis following percutaneous catheterization in infants and children [41]. In addition, small children present delays in performing these tests due to inability to cooperate and increased technical demand, which must be balanced against the care of all active issues.…”

“…Procedures performed for intervention have been found to have a higher incidence of complication than diagnostic procedures [45]. Risk of complications also correlates with younger age, number of catheterizations, and size of catheter [41,45,47,48]. Specifically, age less than 3 years, greater than three catheterizations, and catheter size of at least 6F have been found to increase the rate of complications [45].…”

“…Specifically, age less than 3 years, greater than three catheterizations, and catheter size of at least 6F have been found to increase the rate of complications [45]. Originally, degree of vasospasm was shown to correlate with adverse outcomes [41], but catheter size relative to vessel size was subsequently found to be the determining variable for vasospasm [48].…”

Retrograde cardiovascular angiography in infants, using a 3.6 French catheter

“…Mortenson [9] also demonstrated, angiographically, complete femoral artery occlusion in 6 of 34 patients (18%) studied 2 months to 9 years following percutaneous catheterization . All 34 patients were < 8 years of age at initial study and 5 of the 6 patients with late occlusion had normal distal pulses at the time of repeat study .…”

Endovascular Treatment of Dural Sinus Malformation With Arteriovenous Shunt in a Low Birth Weight Neonate-Case Report-

“…In a large series of patients with vein of Galen aneurysmal malformation, the smallest patient treated by the transfemoral approach weighed 2,800 g. 16) Even in normal weight neonates, the femoral artery is small and insertion of a catheter or vascular sheath might cause severe ischemic and/or thromboembolic complications of the leg. 2,5,22) We believe that insertion of a 4-French vascular sheath to the femoral artery might cause serious ischemic complications in low birth weight neonates.…”