Analysis of Peripheral Vascular Injuries Associated with Catheterizations.
10.4326/jjcvs.31.33
- VernacularTitle:カテーテル挿入による末梢血管損傷の検討 大腿部穿刺例を中心に
- Author:
Hiromi Yano
;
Naoki Konagai
;
Mitsunori Maeda
;
Mikihiko Itou
;
Taisuke Matsumaru
;
Tatsuhiko Kudou
;
Masaharu Misaka
;
Shin Ishimaru
- Publication Type:Journal Article
- From:Japanese Journal of Cardiovascular Surgery
2002;31(1):33-36
- CountryJapan
- Language:Japanese
-
Abstract:
During a 9-year period from January 1991 through December 2000, 30 patients underwent surgical interventions for peripheral vascular injuries associated with catheterizations. Pseudoaneurysm, the most frequent complication, was seen in 19 patients (63.3%). This was followed by arteriovenous fistula in 6 patients (20%), uncontrolled hemorrhage in three (10%), arterial thrombosis in one (3.3%), and pseudoaneurysm complicated with arteriovenous fistula in one patient (3.3%). We performed repair of the puncture site in 26 patients (86.6%), followed by arterial ligation in two (6.6%), thrombectomy combined with percutaneous transluminal angioplasty and aneurysmectomy in one patient (3.3%) respectively. There was a tendency for patients to have diabetes mellitus or hypertension. Though secondary suture had to be performed in two patients with wound infection postoperatively, there was no other complication. In pseudoaneurysmal patients proximal arterial control followed by direct incision into the aneurysm cavity and tangential finger pressure over the hole in the artery was a safe method to control bleeding. In arteriovenous fistula patients aggressive repair resulted in good outcome. In uncontrolled hemorrhage and arterial thrombosis patients prompt intervention is essential. By using accurate techniques in arterial puncture and adequate arterial compression following removal of the catheter, the incidence of vascular injuries can be reduced.
