The value of interventional techniques in the management of symptomatic leg ischaemia complicating transfemoral cardiac procedures.
During a 4 year study period, 3169 coronary arteriograms and 733 coronary angioplasties were carried out at this institution using the percutaneous femoral approach. Seven (0.18%) patients developed symptomatic ischaemia in the leg of the transfemoral access, two (0.06%) after coronary arteriography, four (0.55%) after coronary angioplasty, and one after intraaortic balloon pump insertion for complications during coronary arteriography. Of the three patients with acute leg ischaemia within 24 h of the cardiac procedure, two required emergency surgery and the other was managed by systemic heparinization. Four patients developed intermittent claudication on mobilization after the procedure but referral for angiography was after an interval of 6 days to 12 months. One patient was treated by intra-arterial thrombolysis and three by percutaneous transluminal angioplasty. On follow-up, at 12-36 (mean 20) months, only one patient (who had been treated surgically) had residual symptoms of ischaemia in the leg of the transfemoral access. We conclude that interventional techniques have a useful role to play in the management of symptomatic leg ischaemia complicating transfemoral cardiac procedures.
Department of Radiology, St Bartholomew's Hospital, London.
J E
JE
Dacie
J
J
Goldin
D000208:Acute Disease; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D006801:Humans; D007511:Ischemia / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional; D012189:Retrospective Studies