Incidence of new focal pulmonary emboli after routine cardiac catheterization comparing the brachial to the femoral approach

Abstract

The incidence of pulmonary perfusion defects after routine cardiac catheterization was assessed in 56 patients by comparing ventilation-perfusion (V/Q) lung scans obtained before and 1 day after catheterization. Patients were prospectively randomized in two groups, one in which the brachial approach was performed using an antecubital cutdown procedure, and one in which the percutaneous femoral approach was used. None of the patients with the brachial approach had any ventilation-perfusion mismatch on the V/Q scan; however, three patients (8.3%) with the femoral approach did. These two groups did not differ significantly in clinical characteristics, duration of catheterization, and hemodynamic variables. The data suggest that pulmonary emboli postcardiac catheterization is more frequent in the femoral than the brachial approach. Furthermore, since those pulmonary emboli are mostly asymptomatic, their clinical recognition would be underestimated.

Deep venous thrombosis and pulmonary embolism following cardiac catheterization

“…None of the patients were symptomatic. In a similar study, Gowda et al [8] found an 8.3% incidence of new defects on perfusion lung scans after routine right and left heart catheterization in 50 adult patients using the femoral approach. None of the patients who had their catheterization via the brachial approach had any new defects.…”

Successful coronary pace-termination of ventricular tachycardia during coronary angioplasty

“…The patient was discharged well the next day. [1] first described the technique of coronary pacing during PTCA to avoid additional venous puncture and the associated complications of transvenous pacing wires [2][3][4][5][6]. The value of the technique was further demonstrated prospectively in a group of 300 patients undergoing PTCA by de la Serna et al [7]: 7 patients (2%) required pacing for bradycardias but not for tachycardias.…”