The surgical management of catheter injuries of the brachial artery.

In 84 patients the wrist pulses were lost after diagnostic left heart catheterization via the brachial artery. Sixty-six of these patients underwent surgical exploration of the brachial artery for restoration of pulsatile arterial flow to the hand. This aim was achieved in 64 instances. In all cases, the artery was found to be occluded by fresh thrombus. In 36 patients, balloon thrombectomy and accurate arterial closure were successful. In the remainder, in addition to thrombectomy, indentification of an area of damage to the arterial wall required additional surgical measures, usually in the form of resection and anastomosis. The surgical approach to this problem and the importance of the recognition and treatment of arterial wall damage by the catheter are stressed in this paper.