1. Surgical treatment of brachial artery injuries after cardiac catheterization
- Author
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Kline, Richard M., Jr., Hertzer, Norman R., Beven, Edwin G., Krajewski, Leonard P., and O'Hara, Patrick J.
- Subjects
Cardiac catheterization -- Complications ,Brachial artery -- Injuries ,Health - Abstract
During cardiac catheterization, injury can occur to the artery through which the catheter is passed, such as the brachial artery in the arm. The incidence of injury to the brachial artery has been reported to range from 0.3 to 28 percent. As many as 75 percent of patients with occlusion of the brachial artery will develop claudication (weakness and cramping caused by poor circulation) during exercise. Previously, the authors reported on patients who required brachial artery repair following cardiac catheterization. Patients treated with segmental arterial resection or use of postoperative heparin did not develop postoperative clotting (thrombosis). Recurrent thrombosis was observed more in women than in men, 25 versus 6 percent, respectively. These findings resulted in a change of treatment policy for patients, particularly for women, with brachial artery injury due to cardiac catheterization. Report results are presented using this new protocol. Following cardiac catheterization of 34,191 patients over a eight-year period, 532 patients developed brachial artery injury requiring thrombectomy and repair of the artery. Good forearm pulses were obtained in 514 patients (97 percent); 14 (3 percent) required additional treatment. A delay of surgery for more than one day following catheterization was associated with a higher incidence of rethrombosis. In this series, there was no statistically significant difference between men or women, or between patients who received overnight anticoagulant treatment and those who did not receive overnight anticoagulant treatment. These results suggest that the new measures are effective in improving the immediate results of brachial repair in all patients. (Consumer Summary produced by Reliance Medical Information, Inc.)
- Published
- 1990