Related Experiment Video
Updated: Nov 20, 2025
Use of a Percutaneous Ventricular Assist Device/Left Atrium to Femoral Artery Bypass System for Cardiogenic Shock
Published on: August 16, 2021
Femoral Artery Thrombosis After Pediatric Cardiac Catheterization
Neha Bansal1, Amrit Misra2, Thomas J Forbes2
1Division of Pediatric Cardiology, Children's Hospital at Montefiore, Montefiore Medical Center, 3415 Bainbridge Ave- R1, Bronx, NY, 10467, USA. nbansal@montefiore.org.
Insights
Femoral artery thrombosis (FAT) incidence increased after a monitoring program, particularly in small infants and after sheath exchanges. Early detection is crucial for managing this post-catheterization risk.
Area of Science:
- Cardiology
- Pediatric Interventional Procedures
- Vascular Complications
Background:
- Femoral artery thrombosis (FAT) is a known complication following cardiac catheterization.
- Effective monitoring protocols are essential to identify and mitigate adverse events.
Purpose of the Study:
- To determine the incidence and risk factors of femoral artery thrombosis (FAT) before and after implementing a pulse loss monitoring program.
- To identify patient subgroups and procedural elements associated with an increased risk of FAT.
Main Methods:
- Retrospective review of cardiac catheterization cases using femoral arterial access.
- Comparison of FAT incidence between two eras: pre-protocol (era 1) and post-protocol (era 2).
- Univariable and multivariable logistic regression analyses to identify significant risk factors for FAT.
Main Results:
- Overall FAT incidence was 1.7% (41/2,388 cases).
- FAT incidence was significantly higher in era 2 (3.5 times increase, p < 0.001).
- Key risk factors identified: era, patient weight, sheath exchange, and coarctation intervention. Infants < 7.7 months and < 6.7 kg were at highest risk.
Conclusions:
- The incidence of femoral artery thrombosis (FAT) may be underestimated without a dedicated monitoring program.
- Implementing a pulse loss monitoring program revealed an increased FAT incidence, highlighting the need for vigilance.
- Small infants and complex interventions like coarctation repair with sheath exchanges represent high-risk scenarios for FAT.
Abstract:
Femoral artery thrombosis (FAT) is an adverse event post-catheterization. We decided to study the incidence and risk factors of FAT before and after initiation of a pulse loss monitoring program. All cardiac catheterization cases performed using femoral arterial vascular access were retrospectively reviewed. The study period was divided into two eras: before (era 1), and after the initiation of the protocol (era 2). The primary outcome was FAT requiring therapy. Univariable and multivariable logistic regression models were used to identify factors associated with FAT. Receiver operating characteristic curve were generated to predict FAT. Our cohort consisted of 2,388 cases including 467 (19.6%) infants weighing < 10 kg. The overall incidence of FAT was 1.7% (n = 41). The incidence of FAT was 3.5 times higher in era 2 (p < 0.001). Multivariable model showed that era, weight, sheath exchange, and coarctation intervention were significantly associated with FAT. Infants younger than 7.7 months and less than 6.7 kg were found to be at highest risk for FAT. Our study shows that the incidence of FAT may be underestimated without a monitoring program. Small infants and coarctation interventions requiring larger sheaths or sheath exchanges are at highest risk for FAT.
Related Concept Videos
01:26Cardiac Catheterization IV: Nursing Management
01:28Cardiac Catheterization I: Pre-Procedure Overview
01:21Cardiac Catheterization II: Right Heart Catheterization
01:24Cardiac Catheterization III: Left Heart Catheterization
01:29Venous Thrombosis III: Interprofessional Care
01:23Peripheral Artery Disease V: Postoperative Nursing Management