Vascular complications of percutaneous femoral cardiac interventions. Incidence and operative repair.
Of 7333 patients undergoing percutaneous left-heart catheterization procedures during a seven-year seven-month period, 73 patients (1%) underwent 75 operative repairs of catheterization-related vascular complications. The overall incidence of operative repair varied according to the type of percutaneous femoral artery procedure performed: 0.6% for diagnostic heart catheterization, 0.9% for percutaneous transluminal angioplasty, 5.2% for transfemoral balloon valvuloplasty, and 11.5% for intra-aortic balloon pump placement. This suggests that (1) femoral and iliac artery occlusions can and should be repaired promptly while the patient is under local anesthesia; (2) false aneurysms in this clinical setting can be approached directly through the aneurysm cavity; (3) the diagnosis of false aneurysm or arteriovenous fistula can usually be made on clinical grounds alone, without resorting to angiography; (4) venous or arterial patch angioplasty is the preferred technique for small or severely traumatized femoral arteries; and (5) the necessity for operative repair of these lesions will continue to increase in frequency as percutaneous cardiologic diagnostic and therapeutic interventions are used more widely.
Skillman
J J
JJ
Charles A. Dana Research Institute, Department of Surgery, Harvard Medical School, Boston, MA.
Kim
D
D
Baim
D S
DS
D000328:Adult; D000368:Aged; D000783:Aneurysm / Q000209:etiology; D000800:Angioplasty, Balloon / Q000009:adverse effects; D001157:Arterial Occlusive Diseases / Q000209:etiology; D006328:Cardiac Catheterization / Q000009:adverse effects*; D002404:Catheterization / Q000009:adverse effects; D005260:Female; D005263:Femoral Artery / Q000601:surgery; D006801:Humans; D007083:Iliac Artery / Q000601:surgery; D007423:Intra-Aortic Balloon Pumping / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014652:Vascular Diseases / Q000209:etiology / Q000601:surgery