ABSTRACT
OBJECTIVE: This study prospectively evaluated the impact of sonographic follow-up on the detection rate of access site complications in arterial angiography and determined parameters associated with major complications of the access site after arterial angiography. METHODS: Sonographic follow-up (mean +/- SD, 1.46 +/- 1.11 days after) of the access site (transfemoral, n = 896; and transbrachial, n = 44) was obtained prospectively in 940 arterial angiographies and included evaluations for hematoma, pseudoaneurysm, arteriovenous fistula, arterial dissection, and venous/arterial thrombosis. Clotting parameters, anticoagulation therapy, and several patient and procedure characteristics were recorded. Univariate and multivariate logistic regression analyses were performed. RESULTS: Sonography depicted major access site complications in 39 of 940 angiographies (4.2%). Major access site complications (major local hematoma, n = 13; retroperitoneal hematoma, n = 1; pseudoaneurysm, n = 18; arterial dissection, n = 1; arteriovenous fistula, n = 1; arterial thrombosis, n = 2; and venous thrombosis, n = 3) required conservative (n = 32 [3.4%]) or surgical (n = 7 [0.7%]) treatment. Independent factors significantly associated with major access site complications were age older than 60.33 years and sheath size greater than 5F (P < .05). CONCLUSIONS: Major access site complications were detected in 4.2% of cases and were significantly associated with age and sheath size.
Subject(s)
Angiography/statistics & numerical data , Injections, Intra-Arterial/statistics & numerical data , Peripheral Vascular Diseases/diagnostic imaging , Peripheral Vascular Diseases/epidemiology , Punctures/statistics & numerical data , Ultrasonography/methods , Adolescent , Adult , Aged , Aged, 80 and over , Contrast Media/administration & dosage , Female , Follow-Up Studies , Germany/epidemiology , Humans , Incidence , Male , Middle Aged , Reproducibility of Results , Risk Assessment/methods , Risk Factors , Sensitivity and Specificity , Young AdultABSTRACT
Pediatric arterial thromboembolic stroke is an uncommon condition and rarely is reported to be associated with a cerebral artery fenestration. This clinical report discusses the case of a child with brainstem infarction and basilar artery fenestration. A cardiac source of thromboembolic events could be excluded; however, detailed coagulation analysis revealed in addition an apoliopoprotein(a) size polymorphism. Because we assume that the two concurrent pathologies in combination caused the arterial thromboembolic stroke, the evaluation of all potential triggers including vascular anomalies and coagulation disorders should be considered in unexplained pediatric infarction.
