Angiographic catheter induced arterial occlusion.

Abstract

During a nine year period, the authors treated 37 patients with angiographic catheter induced arterial occlusions. Twenty-nine patients presented with acutely ischemic extremities requiring urgent intervention. Arterial thrombosis followed transfemoral cardiac catheterization or angioplasty in 13 patients, transbrachial catheterization in 13 and peripheral angiography or angioplasty in three. Primary arterial repair was sufficient to restore adequate distal perfusion in 23 patients; however, four required femorofemoral bypass and two required axillofemoral grafts to restore adequate distal perfusion. There were two perioperative deaths and no patient required amputation. Eight patients presented weeks to months after arterial injury. Two patients were minimally symptomatic and were treated without operation. Six patients had significant ischemic symptoms and required arterial bypass operation. All grafts have remained patent during a follow-up period ranging from 18 months to seven years (mean of 28 months). Appropriately planned and executed operative therapy is effective in preventing limb loss and functional impairment in patients with arterial thrombosis after angiographic procedures.