Neuropathy after cardiac catheterization: incidence, clinical patterns, and long-term outcome

Neuropathy is a rare, but potentially morbid, complication of cardiac catheterization. In this study, we report the incidence of this complication and describe its clinical presentation, cause, and natural history.

Between 1988 and 1993, 9585 cardiac catheterizations were performed at this institution. Patients in whom femoral neuropathy developed were identified through a cardiology registry. Hospital and outpatient records and personal interviews were used to determine the presentation and clinical course of each of these patients.

Peripheral neuropathy developed in 20 patients (incidence = 0.21%). Two clinical patterns emerged. In 16 patients, large retroperitoneal hematomas were documented by either computed tomography scanning or by physical examination. These patients were admitted with a lumbar plexopathy involving the femoral, obturator, or lateral femoral cutaneous nerves. Long-term follow-up revealed persistent mild sensory neuropathy in five patients and a mild motor deficit in one. In four patients a groin hematoma or false aneurysm developed which resulted, in paresthesias involving the medial and intermediate cutaneous branches of the femoral nerve. Symptoms completely resolved in all four patients, although false aneurysms were surgically repaired in two.

Neuropathy after cardiac catheterization can be initially disabling, but it is usually completely reversible. Operation is recommended only for coexisting complications.