Complications

2020 ◽  
pp. 277-314
Author(s):  
Andrew Mitchell ◽  
Giovanni Luigi De Maria ◽  
Adrian Banning
Keyword(s):  
Cardiac Catheterization ◽  
Vascular Complications ◽  
Air Embolism ◽  
Limb Ischaemia ◽  
Contrast Nephropathy ◽  
Diagnostic Cardiac Catheterization ◽  
Vasovagal Reactions ◽  
Co Morbidity ◽  
Coronary Perforation ◽  
Haematoma Formation

Cardiac catheterization is an invasive study that involves real risks to the patient. The risks increase with patient age and co-morbidity. Though vascular complications (particularly haematoma formation) and vasovagal reactions are more common, the risk of serious complications from diagnostic cardiac catheterization and coronary angiography remains low. This chapter covers complications that may arise, including death, myocardial infarction, pulmonary oedema, stroke, hypotension, cardiac tamponade, contrast reactions, vasovagal reactions, arrhythmias, vascular complications, limb ischaemia, coronary dissection (including left main stem dissection and iatrogenic type A aortic dissection), air embolism, coronary perforation, renal failure, contrast nephropathy, and cholesterol embolization.

Manual versus mechanical compression for femoral artery hemostasis after cardiac catheterization

1998 ◽  
Vol 7 (4) ◽  
pp. 308-313 ◽  
Author(s):  
A Simon ◽  
B Bumgarner ◽  
K Clark ◽  
S Israel
Keyword(s):  
Cardiac Catheterization ◽  
Femoral Artery ◽  
Vascular Complications ◽  
Control Group ◽  
Mechanical Compression ◽  
Success Rates ◽  
Manual Compression ◽  
Diagnostic Cardiac Catheterization ◽  
Compression Time ◽  
Catheterization Procedure

BACKGROUND: Most cardiac catheterizations are performed via femoral artery access. Reported rates of both peripheral vascular complications and success rates for the use of manual and mechanical compression techniques to achieve femoral artery hemostasis after cardiac catheterization vary. OBJECTIVE: To determine is use of a mechanical clamp is as effective as standard manual pressure for femoral artery hemostasis after cardiac catheterization. METHODS: Subjects consisted of 720 patients from 2 community hospitals who had elective diagnostic cardiac catheterization via the femoral artery. The control group (n=343) received manual compression for hemostasis; the study group (n=377) received mechanical compression. Standard protocols were used for the 2 compression techniques. Pressure was applied for a minimum of 10 minutes for 5F and 6F sheaths and catheters and for a minimum of 15 minutes for 7F and 8F sheaths and catheters. Prospective data were collected and analyzed for each patients, including sheath or catheter size, blood pressure, height, weight, age, time from administration of local anesthetic to successful cannulation of the femoral artery, anticoagulation status, total compression time, physician performing the catheterization procedure, nurse or technician who obtained hemostasis, and complications. In follow-up, patients were asked site-specific and functional status questions 1 to 2 days after the catheterization procedure and again 3 days after the catheterization procedure. RESULTS: Data were analyzed by using frequency distributions, measures of central tendency, and measures of variability. Only 1 difference between the 2 groups was significant: manual compression time was 14.93 +/- minutes, whereas mechanical compression time was 17.13 +/- minutes. CONCLUSION: Mechanical compression is as effective as manual compression for femoral artery hemostasis after cardiac catheterization.

scholarly journals Complications of Diagnostic Cardiac Catheterization in National Heart Centre, Nepal

2017 ◽  
Vol 6 (1) ◽  
pp. 13-16
Author(s):  
Arun Maskey ◽  
Shyam Raj Regmi ◽  
Laxman Dubey ◽  
Yadav Bhatt ◽  
Rabi Malla ◽  
...  
Keyword(s):  
Cardiac Catheterization ◽  
Vascular Complications ◽  
Left Heart ◽  
Coronary Angiogram ◽  
Cerebrovascular Complication ◽  
Artery Thrombosis ◽  
National Heart ◽  
Diagnostic Cardiac Catheterization ◽  
Heart Study ◽  
Venous Fistula

Cardiac Catheterization for diagnostic has been routinely used for the last few years in national heart centre in Nepal. Complications have been recognized as an important factor in morbidity and mortality after diagnostic catheterization. Improvements of technique and technology have reduced the morbidity of routine diagnostic catheterization, but occasional mortality seems to be unavoidable. A total of 6074 consecutive diagnostic cardiac diagnostic cardiac catheterization performed in Shahid Gangalal National Heart Centre, Kathmandu, Nepal between 2004 to 2008 were evaluated for their complications. Among them 4584 (75.46%) were coronary angiogram. 894 (14.71%) were right heart study and 596 (9.81%) were left heart study. There were 5 deaths (0.09%). Four deaths occurred following coronary angiogram and I death following left heart study in a 3 years old boy with Tetralogy of Fallot. Vascular complications occurred in 20(0.33% patients) with groin haematoma in 8 (0.13%), pseudoaneurysm in 5 (0.09%), arterrio venous fistula in 3 (0.05%) and femoral artery thrombosis in 4 (0.06%) patients. Contrast allergy occurred in 7(0.12%), cerebrovascular complication in 3 (0.05%), vasovagal reaction in 5 (0.09%) and pyrogen reaction in 10 (0.16%) of patients. The diagnostic cardiac catheterization in national heart centre has acceptable low rate of complication which includes death.

scholarly journals Difference of Radial Access and Femoral Access on Patient Outcomes in Diagnostic Cardiac Catheterization: A Quasi-Experimental Study

2018 ◽  
Vol 12 (3) ◽  
pp. 73-81
Author(s):  
Xi Cao ◽  
Sui Ying Fung ◽  
Yuen Yi Lai ◽  
Sek Ying Chair ◽  
Han Shi Jocelyn Chew
Keyword(s):  
Back Pain ◽  
Cardiac Catheterization ◽  
Vascular Complications ◽  
Secondary Data ◽  
Transfemoral Approach ◽  
Femoral Access ◽  
Diagnostic Cardiac Catheterization ◽  
Alternative Approach ◽  
Significant Difference ◽  
Quasi Experimental

BackgroundTransfemoral and transradial are two common approaches for performing cardiac catheterization, while there is no consensus on which one is superior to the other.AimThis paper aimed to compare the effect of transfemoral and transradial approaches on patient's outcomes in terms of back pain, vascular complications, and urinary discomfort in those undergoing diagnostic cardiac catheterization.MethodsA secondary data analysis method was used.ResultsThe results showed that transradial access could significantly reduce back pain compared to femoral access. While no significant difference was found for vascular complications and urinary discomfort between the two methods.ConclusionThe findings of this study indicate that transradial approach could reduce patients' back pain without increasing the incidence of vascular complications. Additionally, with early mobility, nursing care time could be reduced. Thus, it can be used as an alternative approach for the transfemoral approach.

Research utilization and improvement in outcomes after diagnostic cardiac catheterization

1998 ◽  
Vol 18 (5) ◽  
pp. 30-31 ◽  
Author(s):  
L Lundin ◽  
T Sargent ◽  
L Burke
Keyword(s):  
Cardiac Catheterization ◽  
Research Utilization ◽  
Quality Care ◽  
Vascular Complications ◽  
Bed Rest ◽  
Review Of The Literature ◽  
Published Evidence ◽  
Diagnostic Cardiac Catheterization ◽  
Iowa Model ◽  
Change In Practice

This research utilization project helped summarize the research basis of current practice related to duration of bed rest after cardiac catheterization via the femoral artery. Several physicians have changed their practice as a result of this project, and the safety of patients is being maintained. Interestingly, De Jong and Morton recently published a research analysis of interventions used to control vascular complications after cardiac catheterization. These authors concluded from the review of the literature on duration of bed rest that evidence was sufficient to support a change in practice. Because we thought that the published evidence was insufficient to be used as the sole basis for a change in practice, we continued to follow the Iowa model. Specifically, we integrated scientific principles and expert recommendations with the published research base; recommended a change in practice; and monitored patients' outcomes, which ultimately did confirm the recommendations of De Jong and Morton. We are convinced that the combination of data from our own patients and the review of the literature was helpful to assure our medical and nursing staff that this change in practice was safe. This project illustrates the benefit of using the Iowa Model for Research Based Practice to Promote Quality Care as a guide to improve patients' outcomes.

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