Management of Acute Complications during Endovascular Procedures in Peripheral Arterial Disease: A Review

Abstract

Endovascular therapy, as opposed to surgical bypass, has become the mainstay for peripheral arterial disease even in long segment occlusions. Complications can occur during the arterial access, catheter manipulation, balloon dilation, and/or stent placement. Given the high prevalence of comorbidities such as diabetes, hypertension, renal dysfunction, and coronary artery disease in these patients, early identification of procedural complications and initiation of treatment are of paramount importance. This review aims to provide comprehensive data on the identification and management of commonly encountered endovascular complications during endovascular interventions in peripheral arterial disease.

Alt Ekstremite Periferik Arter Hastalığında Endovasküler Girişimlerden Kaynaklanan Akut Komplikasyonların Cerrahi Yönetimi: Eskimeyen Yeni

“…Pseudoaneurysms, usually smaller than 2 mm, tend to thrombose spontaneously and can therefore be monitored by serial ultrasonography follow-up. [2,14] The occurrence of pseudoaneurysms following peripheral endovascular interventions can have devastating effects on mortality and morbidity. Therefore, careful patient assessment, close follow-up, and appropriate precautions should be taken to prevent such complications.…”

“…Both the incidence of complications and the type of interventions administered aligned closely with existing literature findings. [14] AVF is more common in patients with hypertension, female gender, and high-dose anticoagulants. AVF usually affects the SFA and profunda femoral arteries and less frequently involves the main femoral artery.…”

“…However, placement of a covered stent at the bifurcation of the CFA is contraindicated because it may lead to the occlusion of the PFA. [14] In such cases, surgical repair should be considered first. During endovascular interventions, caution should be taken against the possibility of AVF complications, and appropriate treatment methods should be utilized if they occur.…”