Vascular injury following cardiac catheterization, coronary angiography, and coronary angioplasty

Abstract

All vascular injuries occurring at this hospital department over a 5-year period (1987-91) as a result of cardiac catheterization, coronary angiography, or coronary angioplasty (PTCA) and requiring transfusion, surgical consultation, or repair, are reviewed. Such complications may occur late and, to detect cases not apparent from the protocol accompanying every examination, a questionnaire was sent to all surgical clinics in the region asking for details of vascular surgical intervention after angiography. The present review of 4879 examinations disclosed 18 patients with 19 vascular injuries (0.39%); four of them were detected by the questionnaire. The types of injury were: pseudoaneurysm (12), thrombembolic episode (4), and excessive bleeding (3). Of the patients with a vascular complication 11 (61%) were receiving anticoagulation treatment, compared to 10% in the whole series; two others suffered from a coagulopathic state. Catheterization was difficult or severe atherosclerosis was present in three, inadvertent mobilization occurred in one, and unintentional puncture distal to the common femoral artery occurred in two patients. With the increasing use of invasive diagnostic and interventional procedures in cardiovascular diseases, knowledge of the type and frequency of possible complications is important, especially of those that may occur late. In the present study anticoagulation, coagulation disorders, and cardiac catheterization combined with brachial puncture and angiography all predisposed to a vascular complication.

Pseudoaneurysm after cardiac catheterization: Therapeutic interventions and their sequelae: Experience in 86 patients

“…This is within the range of 0.05 % to 5.2% reported in literature [1,3,[9][10][11][12]. Most of these studies were performed retrospectively, as was the current study, and only Habscheid et al [11] reported in a prospective study using duplex ultrasound the highest incidence of 5.2%.…”

Cilioretinal artery occlusion during coronary catheterization

“…are well documented (Fransson & Nylander 1994). Two previous patients with retinal branch artery occlusion after percutaneous transluminal coronary angioplasty (Bucci et al 1989, Dickens et al 1994) and after directional coronary atherectomy (Filatov et al 1995) have been reported.…”

Subclavian artery perforation complicating coronary angiography

“…In one case report the site of bleeding was found to be the thymic branch of the right innominate artery. A mediastinal haematoma after cardiac catheterisation may occur from injury of the small vessels near the aortic arch, specially when the transradial approach is used [3][4][5]. Sanmartin et al report on their experience in 3369 cardiac catheterisations via the radial approach performed between 2001 and 2003 [6].…”