| Analysis of Peripheral Vascular
Injuries Associated with Catheterizations |
| Hiromi Yano |
Naoki Konagai |
Mitsunori Maeda |
| Mikihiko Itou |
Taisuke Matsumaru |
Tatsuhiko Kudou |
| Masaharu Misaka* |
Shin Ishimaru* |
|
(Department of Cardiothoracic Surgery, Hachioji
Medical Center of Tokyo Medical University, Tokyo, Japan and
Second Department of Surgery, Tokyo Medical University*, Tokyo,
Japan)
|
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.
Jpn. J. Cardiovasc. Surg. 31：33-36(2002) |
|
