[Incidence and therapy of peripheral arterial vascular complications after heart catheter examinations].
We analyzed the incidence and management of major vascular complications at the arterial puncture site following diagnostic or interventional cardiac catheterization. 27387 cardiac catheterization procedures were performed for diagnostic (n = 19581) or interventional (n = 7806) purposes at our institution during a 7-year study period. A total number of 114 major vascular complications (0.42%) were identified. In 36 (0.13%) patients an arterial occlusion at the puncture site was detected, 34 patients (0.12%) had severe hematoma (blood transfusion or surgical repair necessary), 32 patients (0.12%) developed false aneurysms, 9 patients (0.03%) with av-fistulas and 3 patients (0.01%) had other complications. The following factors were predictive for a significant increase in the incidence of major vascular complications: Female gender, interventional catheterization using larger introducer sheaths and necessitating effective perioperative doses of heparine, and peripheral vascular disease. Operative repair was necessary in 62 patients (54%), 34 patients (30%) were treated conservatively. In 18 patients (17%) acute vascular occlusion could be managed by percutaneous transluminal balloon dilatation and intravascular thrombolysis of the obstruction, in 3 patients additional stent-implantation was necessary in the presence of a large occlusive dissection. Overall the rate of clinically significant major vascular complications is low. In the future a greater number of vascular complications at the entry site for cardiac catheterization will be treated with nonoperative methods (e.g. manual compression of pseudoaneurysms or catheter-based techniques for recanalization of acutely occluded vessels.
Heintzen
M P
MP
Medizinische Klinik und Poliklinik B, Heinrich-Heine-Universität, Düsseldorf.
Schumacher
T
T
Rath
J
J
Ganschow
U
U
Schoebel
F C
FC
Grabitz
K
K
Vester
E G
EG
Leschke
M
M
Köhler
M
M
Strauer
B E
BE
D000328:Adult; D000368:Aged; D017541:Aneurysm, False / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D001157:Arterial Occlusive Diseases / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D001164:Arteriovenous Fistula / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D006328:Cardiac Catheterization / Q000295:instrumentation* / Q000706:statistics & numerical data; D005260:Female; D005263:Femoral Artery / Q000293:injuries; D005858:Germany / Q000453:epidemiology; D006406:Hematoma / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D006801:Humans; D007511:Ischemia / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D007866:Leg / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D011677:Punctures / Q000295:instrumentation; D012307:Risk Factors
Inzidenz und Therapie peripherer arterieller Gefässkomplikationen nach Herzkatheteruntersuchungen.