Percutaneous catheterization of the femoral vessels in children. II. Thrombotic occlusion of the catheterized artery: frequency and causes.

The frequency of, and the conditions which contribute to a reduction of the arterial peak flow to the calves after percutaneous catheterization of the femoral artery were studied by strain gauge plethysmography in 98 catheterizations of children aged 2-16 years. Marked, rapidly disappearing flow reduction, considered to be caused by intense spasm in the femoral artery, occurred in about 5 per cent of cases. Flow reduction under these conditions was generally less marked than at thrombotic occlusion. Thrombotic occlusion of the femoral artery appeared in about 5 per cent of cases, mainly in the younger children and principally in those exposed to catheterizations involving increased risk of intimal trauma. This led to the conclusion that intimal damage is the primary cause of thrombotic occlusion of the femoral artery after catheterization. However, an increased haematocrit value may possibly also promote thrombosis. The arterial blood flow at rest was not abnormally decreased in cases with thrombotic occlusion of the femoral artery. The length of the stay of the catheter in the artery does not seem to be of importance for thrombotic complications. The results indicate that the best way to avoid thrombotic occlusion of the artery at catheterization is to take measures to reduce intimal damage.