[Forensic medical implications of vascular punctures and catheterization and radiologic procedures with diagnostic or therapeutic purpose].
Whatever the aim of the procedure, puncture of a vessel can lead to local complications. Access to the artery carries a risk of hemorrhage, occlusion, stenosis, arteriovenous fistulization or pseudo-aneurysm. The same types of complications can occur in veins. Other complications include skin necrosis due to extravasation of the contrast medium, perforation of the superior vena cava after insertion of an infusion catheter and the risk of pericardial effusion. General complications occur immediately, usually caused by contrast media, or late. There are different examples of secondary legal procedures following punctures involving, with the exception of radiology cases, intraarterial injection at the elbow, perforation of the right atrium by a jugular catheter and acute ischemia of the foot after catheterization of the pedial artery. Legal procedures after radiological procedures were discussed in more detail. The personal experience of the authors and others concerns accidents occurring after arteriography, angioplasty or embolization. Finally, two legal cases after treatment for impotency are analyzed. We focus on a certain number of rules on patient information, preangiography consultation, participation of an anesthetist, careful post-operative follow-up and operation report. Finally, the possibility of radiation-induced arteriopathy is demonstrated by one case reported here.
Natali
J
J
Clinique Bizet, Paris.
Picard
J D
JD
Melki
J P
JP
D000792:Angiography / Q000009:adverse effects; D017130:Angioplasty / Q000009:adverse effects; D002404:Catheterization / Q000009:adverse effects*; D004621:Embolization, Therapeutic / Q000009:adverse effects; D005554:Forensic Medicine; D006801:Humans; D011677:Punctures / Q000009:adverse effects*; D015642:Radiology, Interventional / Q000331:legislation & jurisprudence*