Messina L M, Brothers T E, Wakefield T W, Zelenock G B, Lindenauer S M, Greenfield L J, Jacobs L A, Fellows E P, Grube S V, Stanley J C
Department of Surgery, University of Michigan Medical Center, Ann Arbor.
J Vasc Surg. 1991 May;13(5):593-600. doi: 10.1067/mva.1991.27611.
The purpose of this report is to define the clinical characteristics and outcome of surgical management of vascular complications after interventional cardiac catheterization and to contrast them to those after diagnostic cardiac catheterization. From October 1985 to December 1989, 101 patients were treated for 106 vascular complications after 1866 interventional and 5046 diagnostic cardiac catheterizations at the University of Michigan Medical Center. Interventional catheterizations resulted in 69 vascular complications in 64 patients (frequency 3.4%). The most common interventions included coronary angioplasty (34), of which 10 required percutaneous partial cardiopulmonary bypass, intraaortic balloon pump placement (14), and aortic valvuloplasty (11). Interventional catheter-related complications included hemorrhage (33), arterial thrombosis (18), pseudoaneurysm formation (12), catheter embolization (2), thromboembolism (2), as well as arteriovenous fistula, pseudoaneurysm, and arterial dissection (1 each). Fifteen of these 69 patients (24%) had suffered acute myocardial infarction just before their catheterization. Surgical repair was performed under local anesthesia in 70% of patients. Major vascular reconstructions were required in 9% of patients. Three percent of the involved lower extremities had to be amputated because of complications occurring after arterial puncture. Eight percent of the patients incurring vascular complications after interventional procedures died after operation. Diagnostic catheterizations resulted in 37 vascular complications in 37 patients (frequency 0.7%). In contrast to diagnostic cardiac catheterization, vascular complications after interventional cardiac catheterization occurred more frequently, were most often due to hemorrhage at the vascular access site, and occurred in high-risk, critically ill patients.(ABSTRACT TRUNCATED AT 250 WORDS)
本报告旨在明确介入性心导管术后血管并发症的临床特征及外科治疗结果，并将其与诊断性心导管术后的情况进行对比。1985年10月至1989年12月，密歇根大学医学中心对1866例介入性心导管术和5046例诊断性心导管术后出现的106例血管并发症进行了治疗，共涉及101例患者。介入性心导管术导致64例患者出现69例血管并发症（发生率3.4%）。最常见的介入操作包括冠状动脉血管成形术（34例），其中10例需要经皮部分体外循环，主动脉内球囊反搏置入术（14例），以及主动脉瓣成形术（11例）。介入性导管相关并发症包括出血（33例）、动脉血栓形成（18例）、假性动脉瘤形成（12例）、导管栓塞（2例）、血栓栓塞（2例），以及动静脉瘘、假性动脉瘤和动脉夹层（各1例）。这69例患者中有15例（24%）在导管术前刚发生急性心肌梗死。70%的患者在局部麻醉下进行手术修复。9%的患者需要进行 major 血管重建。因动脉穿刺后出现并发症，3%受累下肢不得不截肢。介入操作后出现血管并发症的患者中有8%术后死亡。诊断性心导管术导致37例患者出现37例血管并发症（发生率0.7%）。与诊断性心导管术相比，介入性心导管术后血管并发症发生更频繁，最常见原因是血管穿刺部位出血，且发生在高危、重症患者中。（摘要截选至250词） （注：“major”此处可能是“主要的”意思，但原文表述不太清晰准确）
