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Post-catheterisation arterial thrombosis in children – pathophysiology, prevention, and treatment

Published online by Cambridge University Press:  27 February 2014

João Silva Marques  and
Cristina Gonçalves
João Silva Marques*
Affiliation:
Department of Cardiology I, Santa Maria Hospital – CHLN, Lisbon Academic Medical Centre, CCUL, Lisbon, Portugal Department of Pharmacology and Neurosciences, Lisbon University Medical School, Lisbon, Portugal
Cristina Gonçalves
Affiliation:
Department of Paediatrics, Santa Maria Hospital – CHLN, Lisbon Academic Medical Centre, Lisbon, Portugal
*
Correspondence to: Dr J. Silva Marques, MD, Department of Cardiology I, Santa Maria Hospital – CHLN, Lisbon Academic Medical Centre, CCUL, 1649-035 Lisbon, Portugal. Tel:+351 916060822; Fax:+351 217805617; E-mail: silvamarques.j@gmail.com
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Abstract

Lower limb ischaemia is the most frequent complication of cardiac catheterisation in children. It is often overlooked, but it can cause significant disability and may limit arterial access sites to repeat diagnostic or interventional catheterisations. A narrative review of the literature on arterial access site thrombosis in children was carried out with a special focus on current evidence that supports preventive and treatment strategies. Anticoagulation, thrombolysis, and thrombectomy have been used successfully to treat arterial access site thrombosis. However, it is not completely established which is the role of each treatment modality and what is the most appropriate timing to deliver it. Therefore, diagnostic and therapeutic strategies have to be prospectively investigated, particularly for clarifying the role of new pharmacologic interventions and of percutaneous and surgical thrombectomy in the current era.

Keywords

Cardiac catheterisationthrombosisanticoagulantsthrombolysisthrombectomy
Type
Review Articles
Information
Cardiology in the Young , Volume 24 , Issue 5 , October 2014 , pp. 767 - 773
Copyright
© Cambridge University Press 2014 

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References

1. Seldinger, SI. Catheter replacement of the needle in percutaneous arteriography; a new technique. Acta Radiol 1953; 39: 368–376.Google Scholar
2. Lurie, PR, Armer, RM, Klatte, EC. Percutaneous guide wire catheterization – diagnosis and therapy. Am J Dis Child 1963; 106: 189–196.Google Scholar
3. Vitiello, R, McCrindle, BW, Nykanen, D, Freedom, RM, Benson, LN. Complications associated with pediatric cardiac catheterization. J Am Coll Cardiol 1998; 32: 1433–1440.Google Scholar
4. Kocis, KC, Snider, AR, Vermilion, RP, Beekman, RH. Two-dimensional and Doppler ultrasound evaluation of femoral arteries in infants after cardiac catheterization. Am J Cardiol 1995; 75: 642–645.Google Scholar
5. Burrows, PE, Benson, LN, Babyn, P, MacDonald, C. Magnetic resonance imaging of the iliofemoral arteries after balloon dilation angioplasty of aortic arch obstructions in children. Circulation 1994; 90: 915–920.Google Scholar
6. Hurwitz, RA, Franken, EA Jr, Girod, DA, Smith, JA, Smith, WL. Angiographic determination of arterial patency after percutaneous catheterization in infants and small children. Circulation 1977; 56: 102–105.Google Scholar
7. Lin, PH, Dodson, TF, Bush, RL, et al. Surgical intervention for complications caused by femoral artery catheterization in pediatric patients. J Vasc Surg 2001; 34: 1071–1078.Google Scholar
8. Franken, EA Jr, Girod, D, Sequeira, FW, Smith, WL, Hurwitz, R, Smith, JA. Femoral artery spasm in children: catheter size is the principal cause. Am J Roentgenol 1982; 138: 295–298.Google Scholar
9. Kocandrle, V, Kittle, CF, Petasnick, J. Percutaneous retrograde abdominal aortography complication. Intimal dissection. Arch Surg 1970; 100: 611–613.Google Scholar
10. Nejad, MS, Klaper, MA, Steggerda, FR, Gianturco, C. Clotting on the outer surfaces of vascular catheters. Radiology 1968; 91: 248–250.Google Scholar
11. Siegelman, SS, Caplan, LH, Annes, GP. Complications of catheter angiography. Study with oscillometry and “pullout” angiograms. Radiology 1968; 91: 251–253.Google Scholar
12. Formanek, G, Frech, RS, Amplatz, K. Arterial thrombus formation during clinical percutaneous catheterization. Circulation 1970; 41: 833–839.Google Scholar
13. Mortensson, W. Angiography of the femoral artery following percutaneous catheterization in infants and children. Acta Radiol Diagn (Stockh) 1976; 17: 581–593.Google Scholar
14. Cartier, R, Pearson, PJ, Lin, PJ, Schaff, HV. Time course and extent of recovery of endothelium-dependent contractions and relaxations after direct arterial injury. J Thorac Cardiovasc Surg 1991; 102: 371–377.Google Scholar
15. Liu, Q, Yan, CW, Zhao, SH, et al. Thrombolytic therapy for femoral artery thrombosis after left cardiac catheterization in children. Chin Med J (Engl) 2009; 122: 931–934.Google Scholar
16. Taylor, LM Jr, Troutman, R, Feliciano, P, Menashe, V, Sunderland, C, Porter, JM. Late complications after femoral artery catheterization in children less than five years of age. J Vasc Surg 1990; 11: 297–304.Google Scholar
17. Bassett, FH III, Lincoln, CR, King, TD, Canent, RV Jr. Inequality in the size of the lower extremity following cardiac catheterization. South Med J 1968; 61: 1013–1017.Google Scholar
18. Bloom, JD, Mozersky, DJ, Buckley, CJ, Hagood, CO Jr. Defective limb growth as a complication of catheterization of the femoral artery. Surg Gynecol Obstet 1974; 138: 524–526.Google Scholar
19. Smith, C, Green, RM. Pediatric vascular injuries. Surgery 1981; 90: 20–31.Google Scholar
20. Lee, HY, Reddy, SC, Rao, PS. Evaluation of superficial femoral artery compromise and limb growth retardation after transfemoral artery balloon dilatations. Circulation 1997; 95: 974–980.Google Scholar
21. Anderson, M, Messner, MB, Green, WT. Distribution of lengths of the normal femur and tibia in children from one to eighteen years of age. J Bone Joint Surg Am 1964; 46: 1197–1202.Google Scholar
22. Moseley, CF. Leg-length discrepancy. Pediatr Clin North Am 1986; 33: 1385–1394.Google Scholar
23. Cardneau, JD, Henke, PK, Upchurch, GR Jr, et al. Efficacy and durability of autogenous saphenous vein conduits for lower extremity arterial reconstructions in preadolescent children. J Vasc Surg 2001; 34: 34–40.Google Scholar
24. Wallace, S, Medellin, H, De, JD, Gianturco, C. Systemic heparinization for angiography. Am J Roentgenol Radium Ther Nucl Med 1972; 116: 204–209.Google Scholar
25. Freed, MD, Keane, JF, Rosenthal, A. The use of heparinization to prevent arterial thrombosis after percutaneous cardiac catheterization in children. Circulation 1974; 50: 565–569.Google Scholar
26. Rao, PS, Thapar, MK, Rogers, JH Jr, et al. Effect of intraarterial injection of heparin on the complications of percutaneous arterial catheterization in infants and children. Cathet Cardiovasc Diagn 1981; 7: 235–246.Google Scholar
27. Girod, DA, Hurwitz, RA, Caldwell, RL. Heparinization for prevention of thrombosis following pediatric percutaneous arterial catheterization. Pediatr Cardiol 1982; 3: 175–180.Google Scholar
28. Saxena, A, Gupta, R, Kumar, RK, Kothari, SS, Wasir, HS. Predictors of arterial thrombosis after diagnostic cardiac catheterization in infants and children randomized to two heparin dosages. Cathet Cardiovasc Diagn 1997; 41: 400–403.Google Scholar
29. Bulbul, ZR, Galal, MO, Mahmoud, E, et al. Arterial complications following cardiac catheterization in children less than 10 kg. Asian Cardiovasc Thorac Ann 2002; 10: 129–132.Google Scholar
30. Hanslik, A, Kitzmuller, E, Thom, K, et al. Incidence of thrombotic and bleeding complications during cardiac catheterization in children: comparison of high-dose vs. low-dose heparin protocols. J Thromb Haemost 2011; 9: 2353–2360.Google Scholar
31. Freed, MD, Rosenthal, A, Fyler, D. Attempts to reduce arterial thrombosis after cardiac catheterization in children: use of percutaneous technique and aspirin. Am Heart J 1974; 87: 283–286.Google Scholar
32. Monagle, P, Chan, AK, Goldenberg, NA, et al. Antithrombotic therapy in neonates and children: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 2012; 141 (Suppl 2): e737S–801S.Google Scholar
33. Brus, F, Witsenburg, M, Hofhuis, WJ, Hazelzet, JA, Hess, J. Streptokinase treatment for femoral artery thrombosis after arterial cardiac catheterisation in infants and children. Br Heart J 1990; 63: 291–294.Google Scholar
34. Zenz, W, Muntean, W, Beitzke, A, Zobel, G, Riccabona, M, Gamillscheg, A. Tissue plasminogen activator (alteplase) treatment for femoral artery thrombosis after cardiac catheterisation in infants and children. Br Heart J 1993; 70: 382–385.Google Scholar
35. Bontadelli, J, Moeller, A, Schmugge, M, et al. Enoxaparin therapy for arterial thrombosis in infants with congenital heart disease. Intensive Care Med 2007; 33: 1978–1984.Google Scholar
36. Bratincsák, A, Moore, JW, El-Said, HG. Low dose tissue plasminogen activator treatment for vascular thrombosis following cardiac catheterization in children: a single center experience. Catheter Cardiovasc Interv 2013; 82: 782–785.Google Scholar
37. Peuster, M, Bertram, H, Fink, C, Paul, T, Hausdorf, G. Percutaneous transluminal angioplasty for the treatment of complete arterial occlusion after retrograde cardiac catheterization in infancy. Am J Cardiol 1999; 84: 1124–1126, A11.Google Scholar
38. Barth, KH, Gosnell, MR, Palestrant, AM, et al. Hydrodynamic thrombectomy system versus pulse-spray thrombolysis for thrombosed hemodialysis grafts: a multicenter prospective randomized comparison. Radiology 2000; 217: 678–684.Google Scholar
39. Castaneda, F, Li, R, Patel, J, DeBord, JR, Swischuk, JL. Comparison of three mechanical thrombus removal devices in thrombosed canine iliac arteries. Radiology 2001; 219: 153–156.Google Scholar
40. Kobayashi, T, Kobayashi, T, Shinohara, M, Tomomasa, T, Morikawa, A. Percutaneous hydrodynamic thrombectomy for femoral arterial thrombosis after arterial catheterization. Pediatr Cardiol 2003; 24: 409–411.Google Scholar
41. Perry, MO. Iatrogenic injuries of arteries in infants. Surg Gynecol Obstet 1983; 157: 415–418.Google Scholar
42. Leblanc, J, Wood, AE, O’Shea, MA, Williams, WG, Trusler, GA, Rowe, RD. Peripheral arterial trauma in children. A fifteen year review. J Cardiovasc Surg (Torino) 1985; 26: 325–331.Google Scholar