Iatrogenic Brachial and Femoral Artery Complications Following Venipuncture in Children

Abstract

Because the incidence of peripheral arterial complications is relatively low in children compared to adults, the diagnostic and therapeutic approaches are extrapolated from the adult guidelines. We proposed that early diagnosis and surgical approach prevented the complications from further developing in the affected extremity in these particular cases.

Management of brachial artery aneurisms in infants

“…Second, routine aneurismectomy should be performed before thromboembolic complications happen [1,2]. In the particular case of Kawasaki's disease, no surgery is needed since most aneurisms regress under high dose of aspirin (50 mg/kg/day anti-inflammatory dose during 10 days, then 5 mg/kg/day until regression).…”

“…Management of brachial artery aneurisms in infants is challenging because of the potential risk of ischemic complications (acute thromboembolic event [1,2], or chronic limb growth disturbance) and because of the surgical difficulty regarding the very little diameter of this artery under 1 year of age (1-2.5 mm). Treatment options and indications are discussed between traditional open surgery and endovascular surgery.…”

The Anatomic Relationship of Femoral Vein to Femoral Artery in Euvolemic Pediatric Patients by Ultrasonography: Implications for Pediatric Femoral Central Venous Access

“…Differences between external landmarks and internal anatomy may lead to complications such as arterial puncture. Femoral artery (FA) puncture has associated with other complications such as pseudoaneurysm, arteriovenous fistula, and embolic events 2 . FV overlap by the FA is known to occur in adults 3 .…”

False Aneurysm of the Brachial Artery Secondary to K-Wire Fixation of a Supracondylar Fracture of the Humerus

“…Arterial puncture during elbow venopunction is the most common cause reported of false aneurysm of brachial artery in children. [6][7][8]11 The first case reported of false aneurysm of a brachial artery branch secondary to a supracondylar fracture in children was attributed to an excessive length of the K-wires. 3 Recently a second case has been reported.…”

“…3,5 The most common cause of false aneurysms of the brachial artery in children is the venipuncture. [6][7][8][9][10][11] Case Report A 7-year-old boy suffered a displaced extension type of supracondylar fracture (Garland II type) of the left humerus after sport accident (►Figs. 1 and 2).…”