Peripheral Vascular Complications from Percutaneous Transluminal Coronary Angioplasty: A Comparison with Transfemoral Cardiac Catheterization

Kaufman, Jeffrey L.; Moglia, Robert; Lacy, Clifton R.; Dinerstein, Charles R.; Moreyra, Abel E.

doi:10.1097/00000441-198901000-00006

Cited by 35 publications

(8 citation statements)

References 13 publications

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“…The frequency of brachial artery entry site was reduced by 83% at follow-up angiography. Complications with the brachial artery entry site were more often local thrombotic occlusion and less likely to be clinically severe or lifethreatening than were the less frequent major complications associated with the femoral artery entry site, similar to other reports [4,[19][20][21]27,28]. Hemorrhage at the catheterization site was the most frequent complication associated with the femoral artery entry site and blood transfusions were more likely to be needed following femoral artery entry site complications.…”

Section: Discussionsupporting

confidence: 85%

“…The incidence of important vascular trauma requiring intervention with surgery (9 of 2,635 patients, 0.34%) was lower than that reported by others (range 0.35-1.6%) [19][20][21]27]. Major vascular complications were significantly more frequent at qualifying angiography in those patients who had a brachial artery entry site (3.3%) than those in whom the entry site was the femoral artery (0.15%) (Table III).…”

Section: Discussionmentioning

confidence: 71%

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Safety of coronary arteriography in clinically stable patients following coronary bypass surgery

Gobel

Stewart

Campeau

et al. 1998

Cathet. Cardiovasc. Diagn.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 71%

Safety of coronary arteriography in clinically stable patients following coronary bypass surgery

Gobel

Stewart

Campeau

et al. 1998

Cathet. Cardiovasc. Diagn.

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“…Eine zu hohe GeffiBpunktion oder eine Perforation der dorsalen A r t e r i e n w a n d in der Region oberhalb des L e i s t e n b a n d e s erh0ht die Gefahr eines retroperitonealen Hfimatoms [53,56,93,96,100]. griffen bei 0,1 bis 2% der Patienten [8,9,36,48,57,75,80,93].…”

Section: Autor Jahrunclassified

“…Eine schwerwiegende, operativ behandlungspflichtige periphere Embolie im Sinne einer Thrombembolie, ausgehend vom Katheter oder vom Punktionsort, wird mit einer H~ufigkeit von 0,03 bis 0,3% der diagnostisch oder interventionell behandelten Ffille selten beschrieben [21,53,75]. Bei Thrombembolien in die Geffigperipherie f~illt klinisch die pl6tzlich ischfimische, kalte, pulslose distale Extremitfit auf.…”

Section: Weitere Bedeutsame Komplikationenunclassified

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Periphere arterielle Komplikationen nach Herzkatheteruntersuchung

Heintzen

Strauer

1998

Herz

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After diagnostic and interventional cardiac catheterization, local vascular complications at the arterial entry site must be expected. With respect to the method applied for catheterization and the puncture site, the type of complications may vary. With transfemoral approach a large variety of vascular complications have to be feared, mostly in the form of bleeding complications and hematomas, arterial dissections or occlusions, pseudoaneurysms and AV-fistulas. Each of these complications may have the potential for serious morbidity. When cardiac catheterization is performed via the arteries of the arm (either in the classical Sones technique by arterial cutdown to the brachial artery or by direct puncture of the brachial or radial artery) vascular occlusions will mostly occur as local vascular complications. These occlusions can often be managed conservatively or by a surgical procedure. The incidence of a vascular complication is mainly dependent on patient-related (sex, age, height, weight, arterial hypertension, diabetes, presence of peripheral vascular disease and compliance of the patient after withdrawal of the sheath) and procedure-related (arterial access site, diagnostic or interventional study, sheath size, periprocedural anticoagulation, duration of intra-arterial sheath placement, faulty puncture technique, operator skill) factors. In addition, the definition of a complication, the publication year of a certain study and the technique used for identification of complications seem to play a role for the reported incidence of peripheral vascular complications after cardiac catheterization. Currently, incidences of 0.1 to 2% for significant local vascular complications after diagnostic transfemoral catheterization are reported, after interventional transfemoral treatment 0.5 to 5% and after complex procedures using large sheath sizes with periprocedural anticoagulation (directional atherectomy, IABP, left-heart assist, valvuloplasty) up to 14%. Following transbrachial and transradial catheterization, local vascular complications at the entry site amount to 1 to 3% after diagnostic and 1 to 5% after interventional procedures. Local vascular complications may be diminished by a cautious and sensitive puncture technique with additional care in patients at higher risk for vascular complications (females, prediagnosed peripheral vascular disease, mandatory anticoagulation, necessity for large sheaths). By using smaller sized catheters and an adequate, defensive anticoagulation regimen, the rate of arterial access site complications may be reduced. Proper methods for achievement of hemostasis as well as a close and careful observation after sheath withdrawal are required.

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Femoral artery pseudoaneurysm: Doppler sonographic features predictive for spontaneous thrombosis

Samuels

Orron

Kessler

et al. 1997

J. Clin. Ultrasound

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Peripheral Vascular Complications from Percutaneous Transluminal Coronary Angioplasty: A Comparison with Transfemoral Cardiac Catheterization

Cited by 35 publications

References 13 publications

Safety of coronary arteriography in clinically stable patients following coronary bypass surgery

Safety of coronary arteriography in clinically stable patients following coronary bypass surgery

Periphere arterielle Komplikationen nach Herzkatheteruntersuchung

Femoral artery pseudoaneurysm: Doppler sonographic features predictive for spontaneous thrombosis

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