Iatrogenic injury from vascular access and endovascular procedures

Endovascular procedures inevitably result in iatrogenic injury in a small percentage of patients. Appropriate choice of access site, careful technique, and selective use of closure devices may reduce the incidence of these complications. The vascular interventionalist should be able to recognize and manage various access site complications, such as pseudoaneurysm, arteriovenous fistula, and retroperitoneal hematoma. Procedural complications such as arterial dissection can often be repaired with endovascular techniques. Newer techniques such as totally percutaneous endovascular aneurysm repair have special considerations to minimize the risk of hemorrhage or limb ischemia. The purpose of this review is to define the more common endovascular complications, their diagnosis, and management.