PERCUTANEOUS REPAIR OF IATROGENIC VASCULA R COMPLICATIONS AFTER ANGIOPLASTY, ANGIOGRAPHY, AND VASCULAR-SURGERY

Purpose: Technical innovations of angioplasty have introduced new ther apeutic options in the treatment of symptomatic arteriosclerotic disea se, Atherectomy devices, aspiration catheters and vascular endoprosthe ses can be used not only for angioplasty purpose but also for correcti on of iatrogenic dissections and thromboembolic; complications. Materi al and methods: 54 patients with vascular complications after surgical (n = 7) and percutaneous (n = 47) interventions were observed in a 5 years period. The complications included acute dissections in 34 cases , acute thrombosis in 4 cases, distal embolism after angioplasty in 14 cases, and two cases with arterial rupture after balloon dilatation. Results: 34 patients with dissections and 18 patients with acute throm bosis were treated. Stent implantation for repair of vessel dissection was successful in 33 of 34 cases. Percutaneous catheter aspiration in combination with local thrombolysis was successful in 4 cases with lo cal thrombosis. Bistal emboli after angioplasty were successfully remo ved using aspiration catheters in 13 of 14 patients. Vessel rupture af ter angioplasty was closed with prolonged balloon dilatation in two pa tients avoiding emergency surgery. Conclusion: Using newly developed i ntravascular technologies such as atherectomy, stents, and catheter as piration, many iatrogenic complications after vascular surgery or vasc ular interventions can be treated. These technologies should be availa ble in every radiology department performing angioplasty.