[The risks involved in the heart catheter examination. A retrospective evaluation of the complications after 700 examinations. IV. Vascular complications (author's transl)].

The review of 700 heart catheterizations in infants and children revealed arterial occlusion in 30 instances after 175 catheterizations (17,1%), but 29 of them after 88 arteriotomies (32,9%) and only 1 after 87 percutaneous arterial catheterizations (1,1%). In two cases thrombectomy of the femoral artery was necessary, brachial artery occlusion was never felt to indicate surgical intervention. Since percutaneous sheath catheterization is used in combination with systemic heparinization no obvious occlusion occurred after about 80 investigations. This may be due to a minimum of intimal damage by the sheath and prohibition of thrombus growth at the site of puncture. Occlusive thrombosis of the femoral vein has been assessed clinically and sometimes angiographically in 7 cases out of 468 (0,4%). In two older children the vein was explored and thrombectomy performed. All other were cyanotic infants; in two of them femoral vein occlusion became manifest as late as two days after investigation by venous cutdown. Thrombosis of inferior vena cava has never been observed neither early nor late. Venous bleeding occurred in 6 infants after vessel disruption and 1 arterial hematoma in a boy because of incomplete compression of puncture site. In 4 instances the catheter could not be inserted because the vessels were too small or too spastic. One time a spring guide entered a small artery in the groin or small pelvic region. Forceful withdrawal stripped the arter. -- This study reveals that the most frequent complication, i. e. arterial occlusion, after adoption of modern techniques does not occur more frequently than in institutions with a larger number of catheterizations per year.