Mocellin R, Schreiber R, Wünschmann H, Bühlmeyer K
Z Kardiol. 1982 Apr;71(4):295-300.
550 retrograde arterial catheterizations, performed between 1974 and 1980, including 50 infants below the age of one year, 120 children between one and 5 years of age and 380 schoolchildren, were reviewed with respect to the rate of complications. Within this period the portion of open arteriotomies decreased from 41% during 1974-1977 to 7% during 1978-1980. Only 130 patients had systemic heparinization during the catheterization procedure, without preponderance of any age group. Complications occurred in 10% of the patients, 4% being major complications necessitating mostly thrombectomia or thrombolysis. The rate of major complications decreased from 6% during the first period (1974-77) to 3% during the second period (1979-80), which can partly be attributed to the decrease of open arteriotomies within the entire period. According to our results the open arteriotomy of the A. femoralis should be avoided as far as possible. The rate of arterial obstructions was highest in infancy, where it amounted to 14%, and did not change considerably between the first and second period of time in this age group. In schoolchildren, however, the rate of arterial obstruction diminished from 7% during the first period to 0.5% during the second period. Considering the entire period, systemic heparinization did not appear to influence significant the rate of complications. During the last 3 years, however, arterial obstruction was observed in none of 74 patients having undergone systemic heparinization, but in 8 of 228 patients without this measure, 7 of them being infants and children below the age of 6 years. We therefore conclude that systemic heparinization should be performed in infants and small children during retrograde catheterization.
回顾了1974年至1980年间进行的550例逆行动脉插管术，其中包括50例1岁以下婴儿、120例1至5岁儿童和380例学龄儿童的并发症发生率。在此期间，开放性动脉切开术的比例从1974 - 1977年的41%降至1978 - 1980年的7%。只有130例患者在插管过程中进行了全身肝素化，各年龄组无明显差异。10%的患者发生了并发症，4%为严重并发症，大多需要进行血栓切除术或溶栓治疗。严重并发症的发生率从第一阶段（1974 - 77年）的6%降至第二阶段（1979 - 80年）的3%，这部分归因于整个时期内开放性动脉切开术的减少。根据我们的结果，应尽可能避免股动脉的开放性动脉切开术。动脉阻塞率在婴儿期最高，达14%，在该年龄组的第一阶段和第二阶段之间没有显著变化。然而，在学龄儿童中，动脉阻塞率从第一阶段的7%降至第二阶段的0.5%。考虑到整个时期，全身肝素化似乎对并发症发生率没有显著影响。然而，在过去3年中，74例接受全身肝素化的患者中无一例发生动脉阻塞，而228例未采取此措施的患者中有8例发生动脉阻塞，其中7例为6岁以下的婴儿和儿童。因此，我们得出结论，在婴儿和幼儿逆行插管期间应进行全身肝素化。
