Incidence and results of arterial complications among 16,350 patients undergoing cardiac catheterization

Abstract

A total of 16,350 patients underwent cardiac catheterization from January 1981 to December 1987. The brachial artery was used in 10,500 patients (group I), and the femoral artery was used in 5850 patients (group II). Surgical intervention for complications was necessary in 60 (0.57%) of the group I patients and in 14 (0.23%) of the group II patients. Hand ischemia in group I and bleeding in group II were the most frequent indications for operation. Procedures performed were segmental resection, vein interposition, and long bypass in group I, and simple suture and angioplasty were performed in group II. Fifty-six patients of the total of 74 underwent early repair (within 48 hours), and 18 patients underwent delayed intervention. Only one (1.7%) of the 56 patients who had early repair had a complication. Five of the 18 patients (28%) with delayed intervention suffered significant complications. Cardiac catheterization by the brachial or femoral route has a low incidence of complications. Delayed intervention is associated with high morbidity despite adequate restoration of circulation. Although there were fewer complications in the femoral group, they were far more serious with respect to life- or limb-threatening events.

Covered stents for endovascular repair of iatrogenic injuries of iliac and femoral arteries

“…In this regard, as long the femoral artery remains the dominant form of vascular access [2], the iliac-femoral axis represents the district exposed to the highest risk of iatrogenic arterial injuries. The most frequent injuries occurring in this vascular bed are rupture, perforation, pseudoaneurysm and arteriovenous fistula [3,4].…”

Management of complex two-chamber false aneurysms by thrombin injections in patients under clopidogrel, aspirin or both

“…The traditional treatment for complex false aneurysms is surgical repair [1,8]. More recently, compression therapy or thrombin injection became the first-line treatment [2,3,4,6,14].…”

“…Previous management of false aneurysms consisted of surgical repair or compression therapy. The main drawbacks of surgery are its invasiveness and the increase of hospitalization time and costs, that of compression therapy pain and prolonged compression bandages [1,3,4,8]. An alternative to both is selective injection of thrombin into the false aneurysm [2,[14][15][16].…”

“…False aneurysms often develop at the puncture after percutaneous cardiovascular procedures [1,8,11,12,13]. Previous management of false aneurysms consisted of surgical repair or compression therapy.…”

Vascular Closure Devices in Interventional Radiology Practice

“…The optimum duration of bed rest remains to be agreed, but published evidence suggests mobilisation at 4 h after MC for an 8F sheath and 3 h after MC for a 5F sheath may be safe [2,3]. Haematomas related to the puncture site are the commonest complication of MC, but most are self-limited [4]. Other potential complications of MC include retroperitoneal haemorrhage, pseudoaneurysm, vessel occlusion and arteriovenous fistula formation.…”