Progressive Protocols for Pediatric Acute Lower Extremity Ischemia Postcatheterization Pediatric Lower Extremity...

Area of Science:

• Pediatric Cardiology
• Vascular Surgery
• Interventional Radiology

Background:

• Pediatric acute lower extremity ischemia postcatheterization (PALIC) presents a critical clinical challenge.
• Minimizing aggressive interventions and complications is key for improved patient outcomes.
• This study evaluates the FAST protocol for managing PALIC.

Purpose of the Study:

• To assess the effectiveness of the FAST protocol in treating pediatric acute lower extremity ischemia after catheterization (PALIC).
• To emphasize the protocol's role in minimizing aggressive interventions and complications.

Main Methods:

• A retrospective analysis of 1,380 pediatric catheterization cases (January 2009-December 2022).
• Evaluation across three stages: pre-FAST, initial FAST adoption, and FAST+ upgrade.
• Monitoring PALIC detection rates, intervention strategies, and complication occurrences.

Main Results:

• Acute lower extremity ischemia (ALI) occurred in 7.1% of cases.
• PALIC detection rates improved significantly with FAST+ (12.1%) compared to initial FAST (4.2%).
• Aggressive interventions decreased from 100% to 0%, and complications reduced from 100% to 1.2% in later stages (P < 0.05).

Conclusions:

• Both FAST and FAST+ protocols are safe and effective for managing PALIC.
• The FAST+ protocol enhances early detection, leading to more effective treatment.
• The study demonstrates a significant reduction in interventions and complications.