Brachial artery lesions after cardiac catheterisation
| Autor: | Stefan H. Skotnicki, Bert C. Eikelboom, P.F.F. Wijn, E.R. Hammacher, H.J.J. van Lier |
|---|---|
| Rok vydání: | 1988 |
| Předmět: |
Cardiac Catheterization
medicine.medical_specialty Brachial Artery Blood Pressure Wrist Palpation Pallor Catheters Indwelling Ischemia Risk Factors Internal medicine medicine.artery Humans Medicine Prospective Studies Brachial artery medicine.diagnostic_test business.industry Hand Capillary refill Blood pressure medicine.anatomical_structure Angiography Cardiology medicine.symptom Cardiology and Cardiovascular Medicine business Segmental blood pressure |
| Zdroj: | European Journal of Vascular Surgery. 2:145-149 |
| ISSN: | 0950-821X |
| DOI: | 10.1016/s0950-821x(88)80066-5 |
| Popis: | In a prospective study the incidence of brachial artery injury after cardiac catheterisation and the factors involved were examined. The main aim of the study however was to determine whether immediately after the injury it was possible to predict if long-term ischaemic symptoms would occur if conservative treatment was used. Five-hundred and two patients were seen pre- and post-catheterisation. Examination included inspection, palpation, segmental blood pressure measurements before and after exercise, Doppler score evaluation and in selected cases, angiography. Twenty-nine patients (5.8%) had postcatheterisation complaints of pain, pallor, hypoaesthesia or paraesthesia. A postcatheterisation wrist blood pressure index of less than 0.85, was found in 97 patients (19%). This included 22 occlusions confirmed by angiography (4.5%). Cardiac valve disease and previous cat heterisations were a risk factor. All brachial artery injuries, that is to say those patients with a postcatheterisation wrist index of less than 0.85, were treated conservatively and reviewed at 6 months. Nineteen of the 72 patients seen at follow-up still had ischaemic symptoms on effort. Postinjury complaints of pain and paraesthesia had no value in predicting whether or not ischaemic symptoms would persist, whilst angiography, wrist pulse palpation, capillary refill time and the wrist pressure index at rest had very little predictive value. The Doppler score, pallor and coldness of the hand all had some value. The best predictor of long-term ischaemic symptoms was the wrist pressure index after exercise. Brachial artery injury occurs frequently after cardiac catheterisation and ischaemic symptoms thereafter are usually mild. If conservative treatment is being considered then it seems safe to do so in patients with a wrist blood pressure index of more than 0.55 after exercise. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|