Barbara Brotschi1, Maja I Hug1, Oliver Kretschmar2, Mattia Rizzi3, Manuela Albisetti4. 1. Division of Intensive Care, University Children's Hospital, Zurich, Switzerland. 2. Division of Cardiology, University Children's Hospital, Zurich, Switzerland. 3. Division of Hematology, University Children's Hospital, Zurich, Switzerland Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada. 4. Division of Hematology, University Children's Hospital, Zurich, Switzerland.
Abstract
OBJECTIVE: Arterial thrombosis is one of the most reported complications of cardiac catheterisation (CC) in children. The aim of the study was to evaluate the incidence and predictors of arterial thrombosis in children with cardiac diseases (CDs). METHODS: During 12 consecutive months, all children aged 0-19 years undergoing CC of the femoral arteries were included in this observational study. After CC, clinical evaluation of impaired limb perfusion was performed according to local guidelines. Doppler ultrasonography was performed when decreased limb perfusion was suspected. RESULTS: 123 children (30% aged <12 months, 70% aged >12 months) underwent CC. Arterial thrombosis occurred in 14 of the 123 children (11.4%). Twelve cases (12/14=86%) of arterial thrombosis occurred in infants aged <12 months and 2 (2/14=14%) in older children. Overall younger age (p<0.01, OR (95% CI) 0.49 (0.28 to 0.86)) and low body weight (p<0.004, OR (95% CI) 0.78 (0.65 to 0.92)) were significantly associated with an increased risk of arterial thrombosis. Cyanotic CD (p=0.07, OR (95% CI) 2.87 (0.90 to 9.15)) showed a trend towards increased thrombotic risk. CONCLUSIONS: Arterial thrombosis is a common complication of CC in infants. Diagnosis of CC-related arterial thrombosis remains a challenge. Well-defined clinical monitoring protocols may be valuable methods for timely detection and treatment of arterial thrombosis. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
OBJECTIVE:Arterial thrombosis is one of the most reported complications of cardiac catheterisation (CC) in children. The aim of the study was to evaluate the incidence and predictors of arterial thrombosis in children with cardiac diseases (CDs). METHODS: During 12 consecutive months, all children aged 0-19 years undergoing CC of the femoral arteries were included in this observational study. After CC, clinical evaluation of impaired limb perfusion was performed according to local guidelines. Doppler ultrasonography was performed when decreased limb perfusion was suspected. RESULTS: 123 children (30% aged <12 months, 70% aged >12 months) underwent CC. Arterial thrombosis occurred in 14 of the 123 children (11.4%). Twelve cases (12/14=86%) of arterial thrombosis occurred in infants aged <12 months and 2 (2/14=14%) in older children. Overall younger age (p<0.01, OR (95% CI) 0.49 (0.28 to 0.86)) and low body weight (p<0.004, OR (95% CI) 0.78 (0.65 to 0.92)) were significantly associated with an increased risk of arterial thrombosis. Cyanotic CD (p=0.07, OR (95% CI) 2.87 (0.90 to 9.15)) showed a trend towards increased thrombotic risk. CONCLUSIONS:Arterial thrombosis is a common complication of CC in infants. Diagnosis of CC-related arterial thrombosis remains a challenge. Well-defined clinical monitoring protocols may be valuable methods for timely detection and treatment of arterial thrombosis. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Authors: Carl H Backes; Sharon L Cheatham; Grace M Deyo; Scott Leopold; Molly K Ball; Charles V Smith; Vidu Garg; Ralf J Holzer; John P Cheatham; Darren P Berman Journal: J Am Heart Assoc Date: 2016-02-12 Impact factor: 5.501
Authors: Ko Eun Lee; Yeon Jeong Seo; Gi Beom Kim; Hyo Soon An; Young Hwan Song; Bo Sang Kwon; Eun Jung Bae; Chung Il Noh Journal: Korean Circ J Date: 2016-03-21 Impact factor: 3.243