VASCULAR COMPLICATIONS AS A RESULT OF IAT ROGENIC FEMORAL-ARTERY CATHETERIZATION

Over a period of 5 years 81 vascular complications after 15,460 cathet erizations of the femoral artery for diagnostic (n = 11,883) or therap eutic (n = 3577) procedures were registered. The following complicatio ns were observed in declining frequency: 1. False aneurysm (n = 65), 2 . arterial occlusion (dissection, embolia, thrombosis) (n = 8), 3. vas cular lesion causing profuse bleeding (n = 7), 4. AV-fistula (n = 1). The total complication rate was 0.52%. The complication rate was signi ficantly higher in therapeutical procedures (1,03%) than in diagnostic investigations (0.37%). Pseudoaneurysms were complicated by thrombosi s of the femoral vein (n = 3), lymphatic fistula (n = 3) and deep woun d infection (n = 9); secondary complication rate 18.5%. Risk factors f or local vascular complications are old age, female gender, high grade arteriosclerosis at the puncture site, overweight, manifest arterial hypertension and medication with cumarin, acetylsalicylic acid or hepa rin. Further complicating factors are connected with technical risks s uch as duration of the procedure, French size of the catheter, the cat heter sheath and multiple punctures. Vascular repair was performed by simple angiorrhaphy in most cases, but in 14.8% more extensive surgica l procedures were required. In patients with signs of occlusive vascul ar disease the external iliac artery was replaced by a PTFE - vascular access graft in 4 cases and an arterioplasty of the deep femoral arte ry was performed in 2 patients. 36% of the operations were undertaken as emergencies. Reintervention was necessary for a postoperative bleed ing complication in 1 case (surgical complication rate 1.2%). A female patient suffering from aortic valve stenosis died during emergency op eration due to massive retroperitoneal hemorrhage after cardiac cathet erization (mortality rate 1.2%). Over a median follow-up period of 37 months no late complications of the intervention were recorded, nor re currences of peripheral arterial occlusive disease.