[Percutaneous transluminal therapy of local arterial vascular occlusion after heart catheterization studies]

Abstract

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.