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Magnetically-Assisted Remote Controlled Microcatheter Tip Deflection under Magnetic Resonance Imaging
Published on: April 4, 2013
Medical emergencies and cardiopulmonary arrests in interventional radiology
Gregory Nadolski1, Amy Praestgaard, Richard D Shlansky-Goldberg
1Division of Interventional Radiology and Department of Radiology, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania.
Purpose:
To evaluate the circumstances and determine the outcomes of medical emergencies (MEs) and cardiopulmonary arrests (CPAs) in patients undergoing interventional radiology (IR) procedures.
Materials And Methods:
Retrospective review of all MEs and CPAs that occurred between July 2006 and December 2011 was performed. Procedure type, technical outcome, complications, etiology and location of ME/CPA, event outcome, and postevent mortality were collected.
Results:
A total of 58 events occurred during 38,927 procedures (0.15%). Complete records were available for 55 events (43 MEs, 12 CPAs) in 53 patients (mean age, 63 y; 58.5% male) during 37 inpatient (27 MEs, 10 CPAs) and 18 outpatient (16 MEs, two CPAs) encounters. Seven events (13%; six MEs, one CPA) occurred before the start of the procedure, and 18 (33%; 16 MEs, two CPAs) occurred in the periprocedural holding area. Thirty-five procedures (64%) were completed successfully. Forty-two patients (76%) were alive at discharge, 37 (67%) at 1 month, 26 (47%) at 3 months, and 23 (42%) at 1 year. Procedural complications were attributed as the main cause of 22 MEs (51%) and one CPA (8%; P = .018). The relative risk (RR) of an ME or CPA occurring during a hemodialysis access case versus all other cases was 5.2 (95% confidence interval = 3.02-8.95; P < .0001).
Conclusions:
Although the incidence of MEs/CPAs in patients undergoing IR procedures is low, the 1-year mortality rate following these events is high. MEs are significantly more likely than CPAs to be directly attributed to a procedural complication. The RR of MEs/CPAs is significantly higher in hemodialysis access interventions.
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