[Percutaneous transluminal therapy of local arterial vascular occlusion after heart catheterization studies].
We analyzed the incidence and management of a vascular occlusion at the arterial puncture site following diagnostic or interventional cardiac catheterization. During the study period 26,245 cardiac catheterization procedures were performed for diagnostic (n = 18,895) or interventional (n = 7350) purposes at our institution. A total number of 35 arterial occlusions (0.13%) was identified. In the early phase of our analysis 14 patients (40%) with peripheral vascular obstruction after cardiac catheterization underwent surgical repair. Three patients (9%) could be treated conservatively. In 18 patients (51%) acute vascular occlusion could be managed by additional intravascular manipulations: 18 patients underwent successful percutaneous transluminal balloon dilatation, in nine patients in combination with intravascular thrombolysis. In three patients additional stent-implantation was necessary in the presence of a large occlusive dissection. The procedure was primarily successful in 16/18 patients. No significant complication occurred. In two patients reocclusion led to operative thrombectomy and patch reconstruction in one and to a second catheter-based approach in the other patient. Both reinterventions were successful. Thus, in experienced hands catheter-based therapy of acute arterial obstruction following diagnostic or interventional cardiac catheterization is very effective and should be considered as therapy of first choice in these patients.
Heintzen
M P
MP
Medizinische Klinik und Poliklinik B, Heinrich-Heine-Universität, Düsseldorf.
Motz
W
W
Leschke
M
M
Schumacher
T
T
Vester
E G
EG
Strauer
B E
BE
D000368:Aged; D000800:Angioplasty, Balloon; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D006328:Cardiac Catheterization; D003131:Combined Modality Therapy; D005260:Female; D005263:Femoral Artery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012008:Recurrence; D015607:Stents; D017131:Thrombectomy; D015912:Thrombolytic Therapy; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000628:therapy; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage
D014568:Urokinase-Type Plasminogen Activator
Perkutane transluminale Therapie des lokalen arteriellen Gefässverschlusses nach Herzkatheteruntersuchungen.