PERCUTANEOUS TRANSLUMINAL TREATMENT OF AC UTE ARTERIAL-OCCLUSION COMPLICATING CARDIAC-CATHETERIZATION

We analyzed the incidence and management of a vascular occlusion at th e arterial puncture site following diagnostic or interventional cardia c catheterization. During the study period 26 245 cardiac catheterizat ion procedures were performed for diagnostic (n = 18 895) or intervent ional (n = 7350) purposes at our institution. A total number of 35 art erial occlusions (0.13%) was identified. In the early phase of our ana lysis 14 patients (40%) with peripheral vascular obstruction after car diac catheterization underwent surgical repair. Three patients (9%) co uld be treated conservatively. In 18 patients (51%) acute vascular occ lusion could be managed by additional intravascular manipulations: 18 patients underwent successful percutaneous transluminal balloon dilata tion, 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 reco nstruction in one and to a second catheter-based approach in the other patient. Both reinterventions were successful. Thus, in experienced h ands catheter-based therapy of acute arterial obstruction following di agnostic or interventional cardiac catheterization is very effective a nd should be considered as therapy of first choice in these patients.