Abstract
Purpose
To evaluate the value and complications of direct graft puncture in conducting interventional procedures in synthetic vascular bypass grafts.
Methods
We retrospectively reviewed 65 direct graft punctures in 50 patients undergoing a variety of interventional vascular procedures. In two patients the grafts were found to be infected and the procedures abandoned.
Results
Complications encountered included hematomas that did not require treatment in three patients, and four hematomas requiring surgical drainage. One graft became infected (despite prophylactic cefuroxime), after three consecutive punctures over a 10-day period for a variety of interventions. All the patients who developed hematomas had undergone pharmacological thrombolysis.
Conclusion
Direct graft puntures is a relatively safe technique, with a minimal risk of infection and hemostatic complications attributable to thrombolysis. In 31 of the 41 patients undergoing successful thrombolysis, additional percutaneous procedures were undertaken, and these were facilitated by the direct graft puncture route.
Similar content being viewed by others
References
Eisenberg RL, Mani RL, McDonald EJ (1976) The complication rate of catheter angiography by direct puncture through aortofemoral bypass grafts. AJR 126:814–816
AbuRahma AF, Robinson PA, Boland JP (1992) Safety of arteriography by direct puncture of a vascular prosthesis. Am J Surg 164:233–236
Page JE, Buckenham TM, Taylor RS (1992) Accelerated thrombolysis facilitated by direct graft puncture of occluded prosthetic femoral grafts. Aust Radiol 36:230–233
Buckenham TM, George CD, Chester JF, Taylor RS, Dormandy JA (1992) Accelerated thrombolysis using pulsed intra-thrombus recombinant human tissue type plasminogen activator (rt-PA). Eur J Vasc Surg 6:237–240
Gardiner GA Jr, Koltun W, Kandarpa K, Whittemore A, Meyerovitz MF, Bettmann MA, Levin DC, Harrington DP (1986) Thrombolysis of occluded femoropopliteal grafts. AJR 147:621–626
Sullivan KL, Gardiner GA, Kandarpa K, Bonn J, Shapiro MJ, Carabasi RA, Smullens S, Levin DC (1991) Efficacy of thrombolysis in infrainguinal bypass grafts. Circulation 83, [Suppl I]: 99–105
Vinnicombe SJ, Heenan SD, Belli A-M, Buckenham TM (1994) Directional atherectomy in the treatment of anastomotic neointimal hyperplasia associated with prosthetic arterial grafts: Technique and preliminary results. Clin Radiol 49:773–778
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Cowling, M.G., Belli, AM. & Buckenham, T.M. Evaluation and complications of direct graft puncture in thrombolysis and other interventional techniques. Cardiovasc Intervent Radiol 19, 82–84 (1996). https://doi.org/10.1007/BF02563898
Issue Date:
DOI: https://doi.org/10.1007/BF02563898