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Emerging predictors of femoral artery occlusion after pediatric cardiac catheterization

Lei Kou1, Qian Wang2, Whitney Annie Long3

  • 1Department of Vascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China.

Scientific Reports
|August 21, 2020
PubMed

Insights

Femoral artery occlusion (FAO) affects 0.9% of children after cardiac catheterization. Longer operation times and higher sheath-to-age ratios are key risk factors for this complication in pediatric patients.

Area of Science:

  • Pediatric Cardiology
  • Vascular Complications
  • Interventional Procedures

Background:

  • Cardiac catheterization is a common procedure in pediatric patients.
  • Femoral artery occlusion (FAO) is a potential complication following these interventions.
  • Understanding FAO prevalence and risk factors in children is crucial for patient safety.

Purpose of the Study:

  • To determine the prevalence of femoral artery occlusion (FAO) in children up to 12 years old undergoing cardiac catheterization.
  • To identify clinical risk factors associated with FAO in this pediatric population.
  • To establish predictive metrics for high-risk FAO cases.

Main Methods:

  • Retrospective review of clinical data from 2,084 pediatric cardiac catheterization cases across two Chinese centers.
  • Univariate and multivariate analyses to assess correlations between FAO and clinical factors (sex, age, height, weight, sheath size, operation time, therapeutic strategy, sheath/age, sheath/height, sheath/weight).
  • Receiver Operating Characteristic (ROC) curve analysis to evaluate predictive value of risk factors.

Main Results:

  • Femoral artery occlusion (FAO) was observed in 19 (0.9%) of the pediatric patients.
  • Higher risk of FAO was associated with younger age, lower height, longer operation time, electrophysiological procedures, and elevated sheath/age, sheath/height, and sheath/weight ratios (p < 0.05).
  • Multivariate analysis identified sheath/age ratio and operation time as independent risk factors. Operation time > 77.5 minutes or sheath/age > 0.5334 significantly increased FAO risk.

Conclusions:

  • Operation time and sheath/age ratio are significant independent predictors of femoral artery occlusion (FAO) post-pediatric cardiac catheterization.
  • Specific thresholds (operation time > 77.5 min, sheath/age > 0.5334) can effectively identify children at high risk for FAO.
  • These findings aid in risk stratification and potentially preventive strategies for FAO in pediatric cardiac procedures.

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