Local Vascular Complications of the Puncture Site in Angiography

ABSTRACT

PURPOSE: To evaluate the types, follow-up studies, and management of local vascular complications of the puncture site in transfemoral angiography. MATERIALS AND METHODS: Fourteen patients who suffered local vascular complications during angiography of postangiographically were evaluated. We reviewed their clinical findings, radiological follow-up studies(Doppler-USG, angiography), treatment and final outcomes. RESULTS: The complications were three cases of perforation which needed emergency treatment, three cases of thrombosis which occurred several hours after angiography, two cases of arteriovenous fistula and two cases of arteriovenous fistula combined with pseudoaneurysm which appeared a few days after angiography, and four cases of pseudoaneurysm that showed variable detection time, from a few days to several months. The causes of complication were faulty puncture sites, carelessness and vascular fragility due to underlying vascular diseases such as diabetes mellitus and atherosclerosis. The complications were evaluated by angiography or doppler-USG and eight cases were treated successfully by interventional methods(manual compression, USG-guided compression, coil embolization,thrombolysis). Five cases needed surgical intervention. It was decided not to treat one case, but only to observe it. CONCLUSION: Local vascular injuries are serious complications occurring during angiography or postangiographically. They may, however, be properly controlled by various interventional techniques. It is important to be aware of their occurrence, findings and method of management.