Vascular complications of cardiac catheterization

Ricci, Michael A.; Trevisani, Gino T.; Pilcher, David B.

doi:10.1016/0002-9610(94)90119-8

Cited by 158 publications

(102 citation statements)

References 9 publications

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“…Additionally, transfemoral cerebral angiography requires patients to tolerate uncomfortable compression of the groin in addition to a several hours of bed rest after the procedure. Finally, this procedure may lead to serious complications, including pseudoaneurysm formation, arteriovenous fistula formation, retroperitoneal hemorrhage, femoral nerve injury, lower limb ischemia, and pulmonary embolism 12,17,19,20) . The transradial approach for coronary angiography was first described by Campeau in 1989 4) .…”

Section: Introductionmentioning

confidence: 99%

Is Transradial Cerebral Angiography Feasible and Safe? A Single Center's Experience

Park

Kim

et al. 2010

J Korean Neurosurg Soc

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Objective : Although a transradial angiography is accepted as the gold standard for cardiovascular procedures, cerebral angiography has been performed via transfemoral approach in most institutions. The purpose of this study is to present our experience concerning the feasibility, efficacy, and safety of a transradial approach to cerebral angiography as an alternative to a transfemoral approach. Methods : Between February 2007 and October 2009, a total of 1,240 cerebral angiographies were performed via a transradial approach in a single center. The right radial approach was used as an initial access route. The procedure continued only after the ulnar artery was proven to provide satisfactory collateral perfusion according to two tests (a modified Allen's test and forearm angiography). Results : The procedural success rate was 94.8% with a mean duration of 28 minutes. All supra-aortic vessels were successfully catheterized with a success rate of 100%. The success rates of selective catheterization to the right vertebral artery, right internal carotid artery, left internal carotid artery, and left vertebral artery were 96.1%, 98.6%, 82.6% and 52.2%, respectively. The procedure was performed more than twice in 73 patients (5.9%), including up to 4 times in 2 patients. The radial artery occlusion was found in 4 patients (5.4%) on follow-up cerebral angiography, but no ischemic symptoms were observed in any of the cases. Conclusion : This study suggests that cerebral angiography using a transradial approach can be performed with minimal risk of morbidity. In particular, this procedure might be useful for follow-up angiographies and place less stress on patients.

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Section: Introductionmentioning

confidence: 99%

Is Transradial Cerebral Angiography Feasible and Safe? A Single Center's Experience

Park

Kim

et al. 2010

J Korean Neurosurg Soc

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“…On the other hand, the transradial approach has caused controversies due to its level of success compared to the other method. Besides, according to prior reports extensive atherosclerotic diseases, atypical anatomy of aortic or brachiocephalic vessels and iliofemoral diseases, etc limit the transfemoral approach [2,8] which is likely to cause groin compression and longer bed rest [15,[20][21][22].…”

Section: Discussionmentioning

confidence: 99%

Transradial Neurointerventional Approach to Basilar Tip Aneurysm: Case Report and Technical Note

Ghorbani

Hejazian

2017

IrJNS

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Cerebral angiography through transfemoral approach is preferred in most of the situations though in cardiovascular surgery transradial angiography is accounted as the superior standard. The present study aimed at presenting our early experience of transradial approach to cerebral angiography and intervention of a patient with basilar tip aneurysm that had inappropriate vasculature to perform routine transfemoral approach. The patient was a 65 year-old man with a large basilar tip aneurysm that was candidate for endosacular coiling through transfemoral route. But due to very tortuous iliac artery, aortic arch and its branches, navigation transfemorraly via both vertebral arteries was impossible. Therefore we decided to do the procedure through right transarterial route. The procedure was started by doing Allen`s test to confirm good perfusion of right hand by collateral arteries. After that cerebral angiography and neurointervention was done transradially without any complication. As a result, although a transradial approach is not a routine way for cerebral angiography and intervention, it can be used safely as an alternative way in specific cases.

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“…1,2 The reported incidence rates for vascular complications after groin puncture in some large series are 0.03%, 0.23%, and 0.1%. [3][4][5] The natural history of these false aneurysms is largely unknown. Classically, repair is usually advised to avoid the complications of rupture, pressure neuropathy, distal ischemia and infection.…”

mentioning

confidence: 99%

“…8,10 There is increased incidence of false aneurysms with therapeutic, as compared to diagnostic, procedures. 5,8,10 These therapeutic procedures are usually associated with the use of large-sized sheaths and catheters, manipulations and post-procedure anticoagulation. However, sheath size failed to reach a statistical significance in one of the studies when correlated with the incidence of post-angiography FA.…”

mentioning

confidence: 99%

“…Most of these patients have an underlying cardiac disease. 5,10 Increased age has also been shown to be correlated with greater incidence of vascular complications after percutaneous cardiac interventional procedures. 5,10 A protocol was established in our institute which involved the cooperation of the cardiologists, the vascular surgeons and the radiologists in the management of these cases.…”

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confidence: 99%

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Management Plan of Post-Angiography False Aneurysms of the Groin

Souka

Buckenham

1999

Ann Saudi Med

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Background: False aneurysm (FA) of the groin is a potentially serious complication of angiographic procedures. We developed a management plan at St. George's Hospital, and prospectively applied it to 14 consecutive cases over a period of one year. Patients and Methods: This report is a prospective cohort study of post-angiography false aneurysms-. Fourteen patients with groin FA presented to the vascular team between October 1995 and September 1996 (0.2% of 6926 angiographic procedures). Nine of the 14 patients were fully anticoagulated at the time of treatment. Ultrasoundguided compression (USGC) was tried in 11 patients and was considered inappropriate in three. Embolization was attempted in four patients and surgery was needed in seven patients. Results: The initial angiographic procedure was therapeutic in nine and diagnostic in five patients. The median maximal dimension of the FA was 3 cm (range 2-5). USGC was successful in three patients and failed in eight, seven of them fully anticoagulated at the time of compression. Embolization of the FA was tried in four patients; all were anticoagulated, and embolization was successful. Surgery was required in seven patients, one with infected groin and bleeding, another with FA at the site of a groin graft anastomosis, three with concomitant evacuation of large groin hematomas, one who refused further angiographic procedures, and one who needed prolonged full anticoagulation before the availability of the embolization. The operation was successful in all the patients except one, who died of myocardial infarction 24 hours after successful surgical closure of a FA. Conclusion: FA can be managed in a step-wise manner, starting with the noninvasive USGC, embolization and surgery. Surgery is indicated if evacuation of a large hematoma is required, or the presence of infection is suspected. Emergency surgery is indicated for bleeding or imminent rupture.

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Vascular complications of cardiac catheterization

Cited by 158 publications

References 9 publications

Is Transradial Cerebral Angiography Feasible and Safe? A Single Center's Experience

Is Transradial Cerebral Angiography Feasible and Safe? A Single Center's Experience

Transradial Neurointerventional Approach to Basilar Tip Aneurysm: Case Report and Technical Note

Management Plan of Post-Angiography False Aneurysms of the Groin

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