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Sheath detachment during coronary arteriogram

J Coy1, G Chatfield

  • 1University of Missouri Hospital and Clinics, Columbia, USA.

Military Medicine
|October 1, 1996
PubMed

Insights

Catheter-sheath separation is a rare complication during angiographic procedures, particularly in patients with significant scarring from lower-extremity amputations. This case highlights the challenges in vascular access for diagnostic imaging in complex trauma patients.

Area of Science:

  • Interventional Cardiology
  • Vascular Surgery
  • Radiology

Background:

  • Angiographic procedures require precise vascular access for diagnostic and therapeutic interventions.
  • Soft-tissue scarring and anatomical deformity can significantly complicate vascular access.
  • Previous trauma, such as blast injuries leading to amputation, can result in extensive scarring.

Observation:

  • The case involved a patient with bilateral lower-extremity amputation secondary to blast injuries.
  • The patient presented with significant soft-tissue scarring and deformity at potential vascular access sites.
  • An attempted coronary arteriogram was complicated by an unusual event.

Findings:

  • Catheter-sheath separation occurred during the attempted coronary arteriogram.
  • This rare complication underscores the technical difficulties in performing angiography in scarred and deformed tissue.
  • The patient's history of blast injuries and amputation was a key factor in the access challenges.

Implications:

  • This case highlights the need for specialized techniques and careful planning for angiographic procedures in patients with complex anatomical alterations.
  • Understanding rare complications like catheter-sheath separation is crucial for improving patient safety in interventional radiology.
  • Further research may be warranted to develop safer vascular access strategies for patients with extensive scarring and deformity.

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