Skip to main content Accessibility help
×
Home

Arterial morbidity following interventional balloon dilation procedures

Published online by Cambridge University Press:  19 August 2008

Amanda Barlow
Affiliation:
From the Department of Cardiology, Royal Children's Hospital, Melbourne
Samuel Menahem
Affiliation:
From the Department of Cardiology, Royal Children's Hospital, Melbourne
James L. Wilkinson
Affiliation:
From the Department of Cardiology, Royal Children's Hospital, Melbourne

Summary

Interventional catheterization procedures performed via the arterial route are well recognized therapies which are being employed with increasing frequency. This review summarizes our experience with local arterial complications of such procedures performed on 44 patients in our institution since 1985. A total of 51 balloon dilations were performed. All patients were heparinized during the procedure. Twenty-one procedures (41%) were followed by clinical evidence of reduced arterial circulation to the affected leg more than four hours after the procedure. Continuing infusion of heparin was used in 17 patients, with return of the pulse concerned in six, while two further patients developed evidence of arterial obstruction after an interval (having initially been found to have ‘satisfactory’ pulses at the end of the procedure). The final infant, whose femoral artery had been torn and could not be repaired, was observed without continuing heparinization. Streptokinase and/or tissue plasminogen activator was employed in eight patients, with resultant success in four. The remaining three, and three who failed thrombolytic therapy, underwent embolectomy. The incidence of arterial damage was related to the size of the catheter (assessed by the size of sheath required to introduce the collapsed balloon, indexed to body surface area) and to low weight or young age at the time of the procedure. No relationship could be established with other variables, including operator, type of catheter, or year or duration of procedure. At long-term follow-up, 11 (22%) patients still have absent or reduced pulses in the leg concerned. Arterial damage following interventional catheterization procedures remains a frequent occurrence despite increasing experience and technical improvements.

Type
Original Manuscripts
Copyright
Copyright © Cambridge University Press 1996

Access options

Get access to the full version of this content by using one of the access options below.

References

1. Kirkpatrick, SE, Takahashi, M, Petry, EL, Stanton, RE, Lurie, PR. Percutaneous heart catheterization in infants and children. Prospective study of results and complications on 127 consecutive cases. Circulation 1970; 42: 10491056.CrossRefGoogle ScholarPubMed
2. Fellows, KE, Radtke, W, Keane, JF, Lock, JE. Acute complications of catheter therapy for congenital heart disease. Am J Cardiol 1987: 60:679683.CrossRefGoogle ScholarPubMed
3. Stanger, P, Heymann, MA, Tarnoff, H, Hoffman, JIE, Rudolph, A. Complications of cardiac catheterization of neonates, infants and children. Circulation 1974; 50: 595608.CrossRefGoogle Scholar
4. Hurwitz, RA, Franken, EA, Girod, DA, Smith, JA, Smith, WL. Angiographic determination of arterial patency after percutaneous catheterization in infants and small children. Circulation 1977; 56: 102105.CrossRefGoogle ScholarPubMed
5. Cassidy, SC, Schmidt, KGT, Van Hare, GF, Stanger, P, Teitel, DF. Complications of pediatric cardiac catheterization: a 3 year study. J Am Coll Cardiol 1992; 19: 12851293.CrossRefGoogle ScholarPubMed
6. Franken, EA, Girod, D, Sequeira, FW, Smith, WL, Hurwitz, R, Smith, JA. Femoral artery spasm in children: catheter size is the principle cause. Am J Roent 1982; 138: 295298.CrossRefGoogle Scholar
7. Hawker, RE, Palmer, J, Bury, RG, Bowdler, LD, Celermajer, JM. Late results of percutaneous retrograde femoral arterial catheterization in children. Br Heart J 1973; 35: 447–39.CrossRefGoogle ScholarPubMed
8. Vermilion, RP, Snider, AR, Bengur, AR, Beekman, RH. Doppler evaluation of femoral arteries in children after aortic balloon valvuloplasty or coarctation balloon angioplasty. Pediatr Cardiol 1993; 14: 1318.Google ScholarPubMed
9. Burrows, PE, Benson, LN, Williams, WG, Trusler, GA, Coles, J, Smallhorn, JF, Freedom, RM. Iliofemoral arterial compli-cations of balloon angioplasty for systemic obstructions in infants and children. Circulation 1990; 82: 16971704.CrossRefGoogle Scholar
10. Saul, JP, Keane, JK, Fellows, KE, Lock, JE. Balloon dilation angioplasty of postoperative aortic obstructions. Am J Cardiol 1987; 59: 943948.CrossRefGoogle ScholarPubMed
11. Tynan, M, Finley, JP, Fontes, V, Hess, J, Kan, J. Balloon angioplasty for the treatment of native coarctation: results of valvuloplasty and angioplasty of congenital anomalies registry. Am J Cardiol 1990; 65: 790792.CrossRefGoogle ScholarPubMed
12. Hellenbrand, WE, Allen, HD, Golinko, RJ, Hagler, DJ, Lutin, W, Kan, J. Balloon angioplasty for aortic recoarctation: results of valvuloplasty and angioplasty of congenital anomalies registry. Am J Cardiol 1990; 65: 793797.CrossRefGoogle ScholarPubMed
13. Mullins, CE, Latson, LA, Neches, WH, Colvin, EV, Kan, J. Balloon dilation of miscellaneous lesions: results of Valvuloplasty and Angioplasty of Congenital Anomalies Registry. Am J Cardiol 1990; 65: 802803.CrossRefGoogle ScholarPubMed
14. Rocchini, AP, Beekman, RH, Shachar, GB, Benson, L, Schwartz, D, Kan, JS. Balloon aortic valvuloplasty: results of the Valvuloplasty and Angioplasty of Congenital Anomalies Registry. Am J Cardiol 1990; 65: 784789.CrossRefGoogle ScholarPubMed
15. Kan, JS, White, RI, Mitchell, SE, Farmlett, EJ, Donahoo, JS, Gardner, TJ. Treatment of restenosis of coarctation by percutaneous transluminal angioplasty. Circulation 1983; 68:10871094.CrossRefGoogle ScholarPubMed
16. Freed, MD, Keane, JF, Rosenthal, A. The use of heparinization to prevent arterial thrombosis after percutaneous cardiac catheterization in children. Circulation 1974; 50: 565569.CrossRefGoogle Scholar
17. Wessel, DL, Keane, LFV, Fellows, KE, Robichaud, H, Lock, JE. Fibrinolytic therapy for femoral artery thrombosis after cardiac catheterization in infants and children. Am J Cardiol 1986; 58: 347351.CrossRefGoogle ScholarPubMed
18. Beckman, RH, Rocchini, AP, Andes, A. Balloon valvuloplasty for critical aortic stenosis in the newborn: influence of new catheter technology. J Am Coll Cardiol 1987; 17: 11721176.CrossRefGoogle Scholar

Full text views

Full text views reflects PDF downloads, PDFs sent to Google Drive, Dropbox and Kindle and HTML full text views.

Total number of HTML views: 0
Total number of PDF views: 5 *
View data table for this chart

* Views captured on Cambridge Core between September 2016 - 21st January 2021. This data will be updated every 24 hours.

Hostname: page-component-76cb886bbf-4qfsd Total loading time: 0.198 Render date: 2021-01-21T06:41:59.227Z Query parameters: { "hasAccess": "0", "openAccess": "0", "isLogged": "0", "lang": "en" } Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": false, "newCiteModal": false }

Send article to Kindle

To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Arterial morbidity following interventional balloon dilation procedures
Available formats
×

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

Arterial morbidity following interventional balloon dilation procedures
Available formats
×

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

Arterial morbidity following interventional balloon dilation procedures
Available formats
×
×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *