Vascular complications of cardiac catheterization

Peripheral vascular complications after cardiac catheterization constitute an increasing portion of traumatic vascular injuries. To determine the incidence of these complications and the sequelae of their treatment, we reviewed 7,690 catheterizations performed over a 40-month period. One hundred eleven vascular complications were detected (1%), 41 of which required surgical repair (0.5%). Pseudoaneurysm (10), arteriovenous fistula (4), thromboembolism (9), infection (5), and other bleeding complications (83) were all found. Significantly more complications occurred in patients who were older than 60 years of age or female (P < 0.0009). In addition, the likelihood of a vascular injury after coronary angioplasty was significantly higher than after angiography alone (3% versus 1%, P < 0.00001). Secondary local and systemic complications after surgical repair were more frequent compared with those injuries that were managed nonoperatively (32% versus 11%; P = 0.015). Vascular complications continue to be a significant problem after cardiac catheterization, especially when coronary angioplasty is performed. The sequelae of surgical repair are significant, adding to their morbidity. Periodic review of these complications may identify factors that might be modified to reduce complications.