This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Zahn, R. Articles by Senges, J. Search for Related Content PubMed PubMed Citation Articles by Zahn, R. Articles by Senges, J. Social Bookmarking                         What's this?

Local Venous Thrombosis After Cardiac Catheterization

LUDWIGSHAFEN AM RHEIN, GERMANY

Elke Fromm, MD

LUDWIGSHAFEN AM RHEIN, GERMANY

Sylvia Thoma, MD

LUDWIGSHAFEN AM RHEIN, GERMANY

Raimond Lotter

LUDWIGSHAFEN AM RHEIN, GERMANY

Matthias Zander, MD

LUDWIGSHAFEN AM RHEIN, GERMANY

Stefan Wagner, MD

LUDWIGSHAFEN AM RHEIN, GERMANY

Karlheinz Seidl, MD

LUDWIGSHAFEN AM RHEIN, GERMANY

Jochen Senges, MD

LUDWIGSHAFEN AM RHEIN, GERMANY

Pulmonary embolism is a rare but life-threatening complication of cardiac catheterization. Underlying deep venous thrombosis (DVT) is often not detectable clinically. To determine the true incidence of DVT the authors prospectively studied 450 consecutive patients (29% women, 71% men, mean age: fifty-eight years) undergoing a diagnostic cardiac catheterization. Patients were examined clinically and by duplex sonography with a high- resolution (5 or 7.5 MHz) transducer before and twenty-four hours after catheterization before mobilization. Duplex sonography excluded complete proximal DVT in all patients. Only partial occluding thrombi (pDVT) were detected in 11 (2.4%) patients. The thrombi were always localized at the puncture site. In 2 patients a difference was found in the circumferences of the legs, but no other clinical signs of DVT were seen. With use of continuous wave (cw) Doppler sonography, only 3 of these 11 patients (27%) showed a spontaneous (s) sound. Phlebography was performed in 4/11 patients (36%). In 2 patients the diagnosis was confirmed; in 1 patient extravenous compression was assumed, and the other demonstrated a normal-appearing phlebography at the time of investigation. Logistic regression analysis yielded a 3.5 times higher risk for developing a pDVT if a venous puncture was performed in addition to arterial puncture. Furthermore a 9.8 times higher risk was found if more than one venous puncture was necessary. During the follow-up no patient developed clinical signs of pulmonary embolism. The results of this study demonstrate that DVT is a rare complication of cardiac catheteriza tion (0/450 patients), but pDVT occurred in 2.4%. Risk factors for pDVT are the venous puncture itself and multiple puncture attempts. Clinical relevance of pDVT remains to be determined.

Angiology, Vol. 48, No. 1, 1-7 (1997)
DOI: 10.1177/000331979704800101


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?