Arterial Thrombus Formation During Clinical Percutaneous Catheterization

Abstract

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 The thrombus which originally encases the catheter will pile up at the puncture site as the catheter is withdrawn.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

Heparinization for prevention of thrombosis following pediatric percutaneous arterial catheterization

“…However, a 7% incidence of arterial occlusion in infants weighing under 7 kg was noted in a late angiographic study of patients we had catheterized [6] . This higher-than-expected incidence of arterial occlusion, together with favorable results of heparinization reported in several adult [4,9,18] and one pediatric study [5] encouraged us to undertake systemic heparinization in an attempt to further reduce the incidence of arterial thrombosis .…”

“…These include formation and propagation of a thrombus initiated by intimal injury at the site of introduction of the arterial needle, guide wire, and catheter, sometimes in association with subintimal dissection and intimal flap formation [11] . Thrombin platelets may become deposited on the catheter and may result in partial or total occlusion of an artery when the catheter is withdrawn [4,13] . Also, arterial spasm, which may occur when the catheter is introduced into the artery, may contribute to thrombus formation [1,11] .…”

Predictors of arterial thrombosis after diagnostic cardiac catheterization in infants and children randomized to two heparin dosages

“…These include formation and propogation of a thrombus initiated by intimal injury at the site of introduction of the arterial needle, guide wire, and catheter, sometimes in association with subintimal dissection and intimal flap formation [11]. Platelets may become deposited on the catheter and may result in partial or total occlusion of an artery when the catheter is withdrawn [12]. Also, arterial spasm, which may occur when the catheter is introduced into the artery, may contribute to thrombus formation [13].…”

The importance of intraoperative angiographic findings for predicting long-term patency in coronary artery bypass operations

“…[65][66][67][68] It is higher in older patients, patients with worse New York Heart Association (NYHA) functional class and multivessel involvement. [61][62][63] Factors such as low patient load 61,69 and prolongation of the procedure time 63,70 are associated with higher complication rates.…”