ANGIOGRAPHIC CATHETER-INDUCED ARTERIAL-OCCLUSION

During a nine year period, the authors treated 37 patients with angiog raphic catheter induced arterial occlusions. Twenty-nine patients pres ented with acutely ischemic extremities requiring urgent intervention. Arterial thrombosis followed transfemoral cardiac catheterization or angioplasty in 13 patients, transbrachial catheterization in 13 and pe ripheral angiography or angioplasty in three. Primary arterial repair was sufficient to restore adequate distal perfusion in 23 patients; ho wever, four required femorofemoral bypass and two required axillofemor al grafts to restore adequate distal perfusion. There were two periope rative deaths and no patient required amputation. Eight patients prese nted weeks to months after arterial injury. Two patients were minimall y symptomatic and were treated without operation. Six patients had sig nificant ischemic symptoms and required arterial bypass operation. Ah grafts have remained patent during a follow-up period ranging from 18 months to seven years (mean of 28 months). Appropriately planned and e xecuted operative therapy is effective in preventing limb loss and fun ctional impairment in patients with arterial thrombosis after angiogra phic procedures.