Vascular injury following cardiac catheterization, coronary angiography, and coronary angioplasty.

All vascular injuries occurring at this hospital department over a 5-year period (1987-91) as a result of cardiac catheterization, coronary angiography, or coronary angioplasty (PTCA) and requiring transfusion, surgical consultation, or repair, are reviewed. Such complications may occur late and, to detect cases not apparent from the protocol accompanying every examination, a questionnaire was sent to all surgical clinics in the region asking for details of vascular surgical intervention after angiography. The present review of 4879 examinations disclosed 18 patients with 19 vascular injuries (0.39%); four of them were detected by the questionnaire. The types of injury were: pseudoaneurysm (12), thrombembolic episode (4), and excessive bleeding (3). Of the patients with a vascular complication 11 (61%) were receiving anticoagulation treatment, compared to 10% in the whole series; two others suffered from a coagulopathic state. Catheterization was difficult or severe atherosclerosis was present in three, inadvertent mobilization occurred in one, and unintentional puncture distal to the common femoral artery occurred in two patients. With the increasing use of invasive diagnostic and interventional procedures in cardiovascular diseases, knowledge of the type and frequency of possible complications is important, especially of those that may occur late. In the present study anticoagulation, coagulation disorders, and cardiac catheterization combined with brachial puncture and angiography all predisposed to a vascular complication.