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Angiographic determination of arterial patency after percutaneous catheterization in infants and small children
Insights
Percutaneous arterial catheterization in children under 25 kg can lead to femoral artery occlusion in 3-8% of cases. This complication may be asymptomatic, necessitating ongoing observation for potential long-term vascular issues.
Area of Science:
- Pediatric cardiology
- Vascular interventions
- Medical imaging
Background:
- Percutaneous arterial catheterization is a common procedure in infants and children.
- Vascular complications, such as femoral artery occlusion, can occur following catheterization.
- Assessing the long-term patency of the femoral artery is crucial for pediatric patient outcomes.
Purpose of the Study:
- To evaluate the angiographic patency of the femoral artery in infants and children after percutaneous arterial catheterization.
- To determine the incidence of femoral artery occlusion in pediatric patients weighing less than 25 kg.
- To identify potential risk factors and clinical implications associated with post-catheterization arterial occlusion.
Main Methods:
- Retrospective analysis of 118 pediatric patients who underwent repeat arterial catheterization.
- Angiographic assessment of femoral artery patency in a subset of patients.
- Review of clinical events surrounding initial catheterization, including pedal pulse assessment.
Main Results:
- Femoral artery occlusion was identified in 4 out of 118 patients (approximately 3.4%).
- All four patients with occlusion were asymptomatic at the time of follow-up, with good pedal pulses.
- Three of the four patients with occlusion experienced decreased pedal pulsations beyond six hours post-initial catheterization.
Conclusions:
- Arterial occlusion occurs in 3-8% of pediatric patients weighing less than 25 kg following percutaneous arterial catheterization.
- Femoral artery occlusion post-catheterization can be asymptomatic, highlighting the need for vigilant follow-up.
- Continued observation is recommended for pediatric patients who experience arterial occlusion to monitor for potential late vascular complications.
Abstract:
Patency of the femoral artery of infants and children who previously had percutaneous arterial catheterization at a weight of less than 25 kg was studied angiographically. During the study period, 118 patients had repeat arterial catheterization. 48 from the opposite leg. Femoral artery occlusion was found in four patients, while 44 of the 48 studied from the opposite leg had complete patency. At the later study, all four with blockage were asymptomatic and possessed good pedal pulses, while two had decreased femoral pulsations. When events surrounding initial catheterization were retrospectively analyzed, three of four had decreased pedal pulsations beyond six hours. It is concluded that 3-8% of patients weighing less than 25 kg have arterial occlusion after catheterization. This complication may be entirely asymptomatic, but these patients will require continued observation for possible late vascular problems.