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The impact of femoral arterial thrombosis in paediatric cardiac catheterisation: a national study

  • Jina Kim (a1), Zhifei Sun (a1), Ehsan Benrashid (a1), Kevin W. Southerland (a1), Jeffrey H. Lawson (a1), Gregory A. Fleming (a2), Kevin D. Hill (a2) and Elisabeth T. Tracy (a1)...

Abstract

Background

Previous studies have identified risk factors for femoral arterial thrombosis after paediatric cardiac catheterisation, but none of them have evaluated the clinical and economic significance of this complication at the population level. Therefore, we examined the national prevalence and economic impact of femoral arterial thrombosis after cardiac catheterisation in children.

Methods

Patients⩽18 years of age who underwent cardiac catheterisation were identified in the 2003–2009 Kids’ Inpatient Database. Patients were stratified by age as follows: <1 year of age or 1–18 years of age. The primary outcome was arterial thrombosis of the lower extremity during the same hospitalisation as cardiac catheterisation. Propensity score matching was used to determine the impact of femoral arterial thrombosis on hospital length of stay, cost, and mortality.

Results

Among the 11,497 paediatric cardiac catheterisations identified, 4558 catheterisations (39.6%) were performed in children <1 year of age. This age group experienced a higher prevalence of reported femoral arterial thrombosis, compared with children aged 1–18 years (1.3 versus 0.3%, p<0.001). After matching, femoral arterial thrombosis in children <1 year of age was associated with similar mortality (5.4 versus 1.8%, p=0.28), length of stay (8 versus 5 days, p=0.11), and total hospital cost ($27,135 versus $28,311, p=0.61), compared with absence of thrombosis.

Conclusions

Femoral arterial thrombosis is especially prevalent in children <1 year of age undergoing cardiac catheterisation. Clinicians should be vigilant in monitoring femoral arterial patency in neonates and infants after cardiac catheterisation.

Copyright

Corresponding author

Correspondence to: J. Kim, MD, Department of Surgery, Duke University Medical Center, Box 3443, Durham, NC 27710, United States of America. Tel: 919 681 3816; Fax: 919 681 7934; E-mail: jina.kim1@duke.edu

References

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1. Bergersen, L, Gauvreau, K, Jenkins, KJ, Lock, JE. Adverse event rates in congenital cardiac catheterization: a new understanding of risks. Congenit Heart Dis 2008; 3: 90105.
2. Bergersen, L, Marshall, A, Gauvreau, K, et al. Adverse event rates in congenital cardiac catheterization – a multi‐center experience. Catheter Cardiovasc Interv 2010; 75: 389400.
3. Bulbul, ZR, Galal, MO, Mahmoud, E, et al. Arterial complications following cardiac catheterization in children less than 10 kg. Asian Cardiovasc Thorac Ann 2002; 10: 129132.
4. Mehta, R, Lee, KJ, Chaturvedi, R, Benson, L. Complications of pediatric cardiac catheterization: a review in the current era. Catheter Cardiovasc Interv 2008; 72: 278285.
5. Phillips, BL, Cabalka, AK, Hagler, DJ, Bailey, KR, Cetta, F. Procedural complications during congenital cardiac catheterization. Congenit Heart Dis 2010; 5: 118123.
6. Saxena, A, Gupta, R, Kumar, RK, Kothari, SS, Wasir, HS. Predictors of arterial thrombosis after diagnostic cardiac catheterization in infants and children randomized to two heparin dosages. Catheter Cardiovasc Diagn 1997; 41: 400403.
7. Stanger, P, Heymann, MA, Tarnoff, H, Hoffman, JI, Rudolph, AM. Complications of cardiac catheterization of neonates, infants, and children: a three-year study. Circulation 1974; 50: 595608.
8. Vitiello, R, McCrindle, BW, Nykanen, D, Freedom, RM, Benson, LN. Complications associated with pediatric cardiac catheterization. J Am Coll Cardiol 1998; 32: 14331440.
9. Kocis, KC, Snider, AR, Vermilion, RP, Beekman, RH. Two-dimensional and Doppler ultrasound evaluation of femoral arteries in infants after cardiac catheterization. Am J Cardiol 1995; 75: 642645.
10. Kulkarni, S, Naidu, R. Vascular ultrasound imaging to study immediate postcatheterization vascular complications in children. Catheter Cardiovasc Interv 2006; 68: 450455.
11. Healthcare Cost and Utilization Project (HCUP). Introduction to the KID, Agency for Healthcare Research and Quality, Rockville, MD, 2009. Retrieved January 2013, from http://www.hcup-us.ahrq.gov/db/nation/kid/kid_2009_introduction.jsp.
12. Bureau of Labor Statistics. CPI Inflation Calculator, US Department of Labor. Retrieved 22 August 2015 from http://www.bls.gov/data/inflation_calculator.htm.
13. Glatz, AC, Keashen, R, Chang, J, et al. Outcomes using a clinical practice pathway for the management of pulse loss following pediatric cardiac catheterization. Catheter Cardiovasc Interv 2015; 85: 111117.
14. Ino, T, Benson, LN, Freedom, RM, Barker, GA, Aipursky, A, Rowe, RD. Thrombolytic therapy for femoral artery thrombosis after pediatric cardiac catheterization. Am Heart J 1988; 115: 633639.
15. Wessel, DL, Keane, JF, Fellows, KE, Robichaud, H, Lock, JE. Fibrinolytic therapy for femoral arterial thrombosis after cardiac catheterization in infants and children. Am J Cardiol 1986; 58: 347351.
16. Bontadelli, J, Moeller, A, Schmugge, M, et al. Enoxaparin therapy for arterial thrombosis in infants with congenital heart disease. Intensive Care Med 2007; 33: 19781984.
17. Lin, PH, Dodson, TF, Bush, RL, et al. Surgical intervention for complications caused by femoral artery catheterization in pediatric patients. J Vasc Surg 2001; 34: 10711078.
18. Punzalan, RC, Hillery, CA, Montgomery, RR, Scott, JP, Gill, JC. Low-molecular-weight heparin in thrombotic disease in children and adolescents. J Pediatr Hematol Oncol 2000; 22: 137142.
19. Lee, HY, Reddy, SCB, Rao, PS. Evaluation of superficial femoral artery compromise and limb growth retardation after transfemoral artery balloon dilatations. Circulation 1997; 95: 974980.
20. Taylor, LM, Troutman, R, Feliciano, P, Menashe, V, Sunderland, C, Porter, JM. Late complications after femoral artery catheterization in children less than five years of age. J Vasc Surg 1990; 11: 297306.
21. Girod, DA, Hurwitz, RA, Caldwell, RL. Heparinization for prevention of thrombosis following pediatric percutaneous arterial catheterization. Pediatr Cardiol 1982; 3: 175180.
22. Koelemay, MJ, den Hartog, D, Prins, MH, Kromhout, JG, Legemate, DA, Jacobs, MJ. Diagnosis of arterial disease of the lower extremities with Duplex ultrasonography. Br J Surg 1996; 83: 404409.
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Cardiology in the Young
  • ISSN: 1047-9511
  • EISSN: 1467-1107
  • URL: /core/journals/cardiology-in-the-young
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