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Delayed, distant arterial injury after brachial artery catheterization
Insights
Iatrogenic arterial injury from angiography catheterization can cause absent pulses. Late thrombotic complications months after the procedure are possible, even from injuries proximal to the catheter site.
Area of Science:
- Vascular Surgery
- Interventional Radiology
Background:
- Iatrogenic arterial injury is a known complication of angiography.
- Post-catheterization evaluation is crucial for identifying arterial issues.
Observation:
- A significant percentage of patients (0.3-24%) undergoing brachial artery catheterization experience diminished or absent radial pulse.
- Most cases resolve with local exploration of the arteriotomy site.
Findings:
- Late thrombotic complications can manifest months after angiography.
- These late complications may result from arterial injury proximal to the catheterization site.
Implications:
- Clinical vigilance for delayed complications is essential.
- Further research into the mechanisms of late thrombotic events is warranted.
Abstract:
The occurrence of iatrogenic arterial injury secondary to catheterization for angiographic studies has been well documented in the literature for over a decade. It has been well established that patients should be carefully evaluated post-catheterization and if absence of the pulse distal to the arteriotomy site is discovered, most should undergo exploration for identification and correction of the problem. Between 0.3 and 24% of patients undergoing brachial artery catheterization have been found to have a diminished or absent radial pulse after the procedure. In the vast majority of cases the problem has been solved by local exploration of the arteriotomy site. However, in a small but definite number of cases late thrombotic complications have become manifest, and in two cases reported in 1981 and in the case report to follow, thrombotic complications have become manifest months later, secondary to injury well proximal to the arteriotomy site.