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Safety of cardiac catheterization via peripheral vascular grafts
E J Lesnefsky1, F P Carrea, B M Groves
1Division of Cardiology, University of Colorado Health Sciences Center, Denver.
Insights
Cardiac catheterization via peripheral bypass grafts is safe. This study found no increased complications or technical issues when accessing arteries through prosthetic grafts for cardiac procedures.
Area of Science:
- Cardiology
- Vascular Surgery
Background:
- Limited data exists on complications of cardiac catheterization using peripheral bypass grafts for vascular access.
- Assessing outcomes in patients undergoing arterial access via prosthetic graft puncture is crucial.
Purpose of the Study:
- To evaluate in-hospital clinical outcomes, complications, and technical difficulties of cardiac catheterization using prosthetic peripheral bypass grafts for arterial access.
Main Methods:
- Retrospective review of cardiac catheterizations performed between January 1, 1984, and April 1, 1991.
- Analysis of 17 procedures involving percutaneous puncture of vascular grafts out of 2,929 total arterial catheterizations.
- Use of arterial sheaths (5F in 53%, 7F or larger in 47%) in all cases.
Main Results:
- No intraprocedural or postprocedural complications were observed.
- One case experienced technical difficulty with selective right coronary artery cannulation.
- Average time from graft placement to catheterization was 7.5 +/- 1.1 years.
Conclusions:
- Percutaneous arterial sheath insertion for cardiac catheterization via remotely implanted vascular bypass grafts is associated with a low risk of complications.
- This approach does not present increased technical difficulties compared to traditional methods.
Abstract:
There are few data concerning the complications and technical difficulties encountered when cardiac catheterization is performed using peripheral bypass grafts for vascular access. All cardiac catheterizations performed at our institution from January 1, 1984 to April 1, 1991 were retrospectively reviewed to assess the in-hospital clinical outcomes in patients who had arterial access for catheterization achieved via prosthetic graft puncture. Seventeen procedures had percutaneous puncture of a vascular graft from a total of 2,929 arterial catheterizations performed. The interval from graft placement to catheterization was 7.5 +/- 1.1 years. Arterial sheaths were employed in all cases and corresponded to the catheter size, with 5F systems used in 53% and 7F or larger systems used in the remaining patients. No intraprocedural or postprocedural complications were recognized. Technical difficulties were limited to the inability to selectively cannulate a nondominant right coronary artery in 1 patient. We conclude that percutaneous introduction of an arterial sheath and left heart catheterization via remotely implanted vascular bypass grafts is not associated with an increased risk of procedural complications or technical difficulties.