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Vascular Access and Management of Its Complications

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Abstract

Vascular access is needed to realize the potential of therapeutic cardiac catheterization and may consume up to 25% of the entire procedure time. Repeat interventions and multiple cardiac surgeries may result in incremental loss of access sites. The following article discusses general aspects of vascular access, imaging tools to facilitate access, the various access sites with technical approach, advantages, and specific complications. Strategies for vessel protection and management of acute bleeding and iatrogenic fistulas are presented. Also, strategies for vessel restoration after acute and chronic vascular occlusion are reviewed.

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References

  1. D Balaguru M Dilawar P Ruff WAK Radtke (2003) ArticleTitleEarly and late results of thrombolytic therapy using tissue-type plasminogen activator to restore arterial pulse after cardiac catheterization in infants and small children Am J Cardiol 91 908–910 Occurrence Handle10.1016/S0002-9149(03)00037-7 Occurrence Handle12667589

    Article  PubMed  Google Scholar 

  2. WM Book AA Raviele RN Vincent (1998) ArticleTitleRepetitive percutaneous transhepatic access for myocardial biopsy in pediatric cardiac transplant recipients Cathet Cardiovasc Diagn 45 167–169 Occurrence Handle10.1002/(SICI)1097-0304(199810)45:2<167::AID-CCD14>3.0.CO;2-I Occurrence Handle9786397

    Article  PubMed  Google Scholar 

  3. WM Book AA Raviele RN Vincent (1999) ArticleTitleTranshepatic vascular access in pediatric cardiology patients with occlusion of traditional central venous sites J Invasive Cardiol 11 341–344 Occurrence Handle10745545

    PubMed  Google Scholar 

  4. F Cetta LC Graham BW Eidem (2000) ArticleTitleGaining vascular access in pediatric patients: use of the P.D. Access Doppler Needle Cathet Cardiovasc Intervent 51 61–64 Occurrence Handle10.1002/1522-726X(200009)51:1<61::AID-CCD14>3.0.CO;2-U

    Article  Google Scholar 

  5. JP Cheatham TC McCowan SE Fletcher (1999) ArticleTitlePercutaneous translumbar cardiac catheterization and central venous line insertion: an alternative approach in children with congenital heart disease Cathet Cardiovasc Intervent 46 187–192 Occurrence Handle10.1002/(SICI)1522-726X(199902)46:2<187::AID-CCD14>3.0.CO;2-S

    Article  Google Scholar 

  6. HE Cohn MD Freed WF Hellenbrand DC Fyler (1985) ArticleTitleComplications and mortality associated with cardiac catheterization in infants under one year: a prospective study Pediatr Cardiol 6 123–131 Occurrence Handle4080571

    PubMed  Google Scholar 

  7. KE Fellows W Radtke JF Keane JE Lock (1987) ArticleTitleAcute complications of catheter therapy for congenital heart disease Am J Cardiol 60 679–683 Occurrence Handle10.1016/0002-9149(87)90381-X Occurrence Handle3661434

    Article  PubMed  Google Scholar 

  8. MD Freed JF Keane A Rosenthal (1974) ArticleTitleThe use of heparinization to prevent arterial thrombosis after percutaneous cardiac catheterization in children Circulation 50 565–569 Occurrence Handle4607271

    PubMed  Google Scholar 

  9. RM Grady PR Eisenberg ND Bridges (1995) ArticleTitleRational approach to use of heparin during cardiac catheterization in children J Am Coll Cardiol 25 725–729 Occurrence Handle10.1016/0735-1097(94)00438-V Occurrence Handle7860920

    Article  PubMed  Google Scholar 

  10. P Guccione MG Gagliardi M Bevilacqua F Parisi B Marino (1992) ArticleTitleCardiac catheterization through the internal jugular vein in pediatric patients. An alternative to the usual femoral vein access Chest 101 1512–1514 Occurrence Handle1600766

    PubMed  Google Scholar 

  11. FF Ing TE Fagan RG Grifka et al. (2001) ArticleTitleReconstruction of stenotic or occluded iliofemoral veins and inferior vena cava using intravascular scents: re-establishing access for future cardiac catheterization and cardiac surgery J Am Coll Cardiol 37 251–257 Occurrence Handle10.1016/S0735-1097(00)01091-3 Occurrence Handle11153747

    Article  PubMed  Google Scholar 

  12. JL Johnson KE Fellows JD Murphy (1995) ArticleTitleTranshepatic central venous access for cardiac catheterization and radiologic intervention Cathet Cardiovasc Diagn 35 168–171 Occurrence Handle7656314

    PubMed  Google Scholar 

  13. TA Johnston LF Donnelly DP Frush MP O’Laughlin (2003) ArticleTitleTranshepatic catheterization using ultrasound-guided access Pediatr Cardiol 24 393–396 Occurrence Handle10.1007/s00246-002-1400-0 Occurrence Handle12545325

    Article  PubMed  Google Scholar 

  14. M Kelm SM Perings T Jax et al. (2002) ArticleTitleIncidence and clinical outcome of iatrogenic femoral arteriovenous fistulas J Am Coll Cardiol 40 291–297 Occurrence Handle10.1016/S0735-1097(02)01966-6 Occurrence Handle12106934

    Article  PubMed  Google Scholar 

  15. KO Maher KA Murdison WI Norwood JD Murphy (2004) ArticleTitleTransthoracic access for cardiac catherization Catheter Cardiovac Interv 63 72–77 Occurrence Handle10.1002/ccd.20080

    Article  Google Scholar 

  16. M Peuster H Bertram C Fink T Paul G Hausdorf (1999) ArticleTitlePercutaneous transluminal angioplasty for the treatment of complete arterial occlusion after retrograde cardiac catheterization in infancy Am J Cardiol 84 1124–1126 Occurrence Handle10.1016/S0002-9149(99)00518-4 Occurrence Handle10569683

    Article  PubMed  Google Scholar 

  17. WAK Radtke BR Waller A Hebra SM Bradley (2002) ArticleTitlePalliative stent implantation for aortic coarctation in premature infants weighing <1500 g. Am J Cardiol 90 1409–1412 Occurrence Handle10.1016/S0002-9149(02)02887-4 Occurrence Handle12480059

    Article  PubMed  Google Scholar 

  18. D Shim TR Lloyd RH Beekman (1999) ArticleTitleTranshepatic therapeutic cardiac catheterization: a new option for the pediatric interventionalist. Cathet Cardiovasc Intervent 47 41–45 Occurrence Handle10.1002/(SICI)1522-726X(199905)47:1<41::AID-CCD8>3.0.CO;2-Y

    Article  Google Scholar 

  19. D Shim TR Lloyd KJ Cho CP Moorehead RH Beekman (1995) ArticleTitleTranshepatic cardiac catheterization in children: evaluation of efficacy and safety. Circulation 92 1526–1530 Occurrence Handle7664436

    PubMed  Google Scholar 

  20. R Vitello BW McCrindle D Nykanen RM Freedom LN Benson (1999) ArticleTitleComplications associated with pediatric cardiac catheterization. J Am Coll Cardiol 32 1433–1440 Occurrence Handle10.1016/S0735-1097(98)00396-9

    Article  Google Scholar 

  21. J Waigand F Uhlich CM Gross C Thallhammer R Dietz (1999) ArticleTitlePercutaneous treatment of pseudoaneurysms and arteriovenous fistulas after invasive vascular procedures. Cathet Cardiovasc Intervent 47 157–164 Occurrence Handle10.1002/(SICI)1522-726X(199906)47:2<157::AID-CCD5>3.0.CO;2-Y

    Article  Google Scholar 

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Correspondence to W.A.K. Radtke.

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Radtke, W. Vascular Access and Management of Its Complications. Pediatr Cardiol 26, 140–146 (2005). https://doi.org/10.1007/s00246-004-0954-4

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