Vascular ultrasound imaging to study immediate postcatheterization vascular complications in children

Abstract

Vascular occlusion is the major complication of percutaneous cardiac catheterization in children. This is a prospective study to evaluate post catheterization vascular complications in 120 consecutive children with the help of vascular ultrasound and Doppler imaging. Ultrasound imaging of both iliac and femoral veins and arteries was done one hour prior and 24 hours after cardiac catheterization. Patients with prior thrombus or occlusion of femoral/iliac vein or artery due to previous cardiac catheterization were excluded from the study. Age of the patients ranged from 22 days to 12 years with a mean of 56 months and weight ranged from 3 to 57 kg with a mean of 14.3 kg. Procedure time was less than 60 minutes in 74 patients (61.66%) and more than 60 minutes in 46 patients (38.33%). 4F sized arterial sheath was used in 108 patients. 5F or bigger sized arterial sheath was used in remaining 12 patients. Incidence of arterial occlusion was higher in patients weighing less than 10 kg (16%) as compared with patients weighing more than 10 kg (5.5%) {P = 0.031}. Arterial thrombosis was more in infants (16%) as compared with older children (7%) {P = 0.203} Prolonged procedure time or use of larger sized sheath did not have higher incidence of arterial occlusion. Venous thrombosis was found in 2 patients (1.66%) who had 5F venous sheath. One patient had arterio venous fistula. Our study shows vascular ultrasound imaging can provide anatomical details of femoral and iliac vessels and is a easier and accurate method of assessing post-catheterization vascular complications in children.