PERIPHERAL VASCULAR COMPLICATIONS ON HEAR T CATHETERIZATIONS

Over a period of 30 months (1. 1. 89-30. 6. 91) 3516 patients who had either a diagnostic (2718) or therapeutic (798) heart catheterization were followed for local vascular complications. 774 patients were inve stigated prospectively. The following complications were observed in d eclining frequency: 1. relevant haematoma, 2. pseudoaneurysm, 3. arter iovenous fistula, 4. arterial thrombosis/dissection, 5. venous thrombo sis, 6. rupture of the vessel, 7. local infection. The total complicat ion rate was 2.22 %. With prospective investigation it was significant ly higher (3.23 %) than with retrospective investigation (1.93 %). The complication rate was also significantly higher in therapeutical proc edures (3.76 %) than in diagnostic catheterizations (1.76 %). Factors associated with a significantly higher incidence of local vascular com plications were age (p < 0.01), female gender (p < 0.025), manifest ar terial hypertension (p < 0.005), aortic regurgitation (p < 0.1), perii nterventional medication with acetylsalicic acid and full dose heparin (p < 0.001), full dose heparin alone (p < 0.001) or fibrinolysis-ther apy (p < 0.025). Relevant technical factors were: duration of the proc edure, duration of the placement of the catheter-sheath, French size o f the catheter, left femoral access, arterial and venous access at one extremity. In about half of the cases the treatment of the complicati ons was conservative, in the other half it was surgical (51 %). In rel ation to all surgically treated patients the percentage of emergency o perations was 25 %, the percentage of reoperations was 15 %.