[The percutaneous treatment of surgical and catheter-angiographic vascular complications].
OBJECTIVE
Technical innovations of angioplasty have introduced new therapeutic options in the treatment of symptomatic arteriosclerotic disease. Atherectomy devices, aspiration catheters and vascular endoprostheses can be used not only for angioplasty purpose but also for correction of iatrogenic dissections and thromboembolic complications.


METHODS
54 patients with vascular complications after surgical (n = 7) and percutaneous (n = 47) interventions were observed in a 5 years period. The complications included acute dissections in 34 cases, acute thrombosis in 4 cases, distal embolism after angioplasty in 14 cases, and two cases with arterial rupture after balloon dilatation.


RESULTS
34 patients with dissections and 18 patients with acute thrombosis were treated. Stent implantation for repair of vessel dissection was successful in 33 of 34 cases. Percutaneous catheter aspiration in combination with local thrombolysis was successful in 4 cases with local thrombosis. Distal emboli after angioplasty were successfully removed using aspiration catheters in 13 of 14 patients. Vessel rupture after angioplasty was closed with prolonged balloon dilatation in two patients avoiding emergency surgery.


CONCLUSIONS
Using newly developed intravascular technologies such as atherectomy, stents, and catheter aspiration, many iatrogenic complications after vascular surgery or vascular interventions can be treated. These technologies should be available in every radiology department performing angioplasty.
Berger
H
H
Institut für Radiologische Diagnostik, Ludwig-Maximilians-Universität München.
Steiner
W
W
Waggershauser
T
T
Stäbler
A
A
Szeimies
U
U
Rau
H
H
D000208:Acute Disease; D000792:Angiography / Q000009:adverse effects*; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D017073:Atherectomy / Q000009:adverse effects; D001807:Blood Vessel Prosthesis; D001808:Blood Vessels / Q000293:injuries*; D002406:Catheterization, Peripheral / Q000009:adverse effects; D004617:Embolism / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D012189:Retrospective Studies; D012421:Rupture; D015607:Stents; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy