부산대학교 도서관

Percutaneous transluminal coronary angioplasty is a procedure used to treat blockage or narrowing of the coronary arteries, which bring blood to the heart. In the angioplasty procedure, a large-diameter catheter is threaded into the narrowed coronary artery. But the first step is to insert the catheter into the arterial system of the body; the most common site for arterial access is the femoral (thigh) artery. Increasing use of these procedures has resulted in a higher rate of injury to the femoral artery. A study was undertaken of 144 patients who, over a 14-month period, underwent percutaneous transluminal coronary angioplasty. These patients were evaluated for injury at the site of femoral puncture. Following angioplasty, patients were evaluated by a surgeon and underwent a duplex scan of the groin. Based on the initial scan, the rate of major vascular complications was 9 percent. These 13 complications included pseudoaneurysms (localized wall thinning), arteriovenous fistulas (abnormal connection between an artery and a vein), and thrombosed superficial femoral artery (clot formation). The formation of the pseudoaneurysm was associated with the use of heparin at the end of the procedure, when the arterial sheath was removed. All pseudoaneurysms thrombosed (clotted) spontaneously without adverse consequences. This finding suggests that asymptomatic pseudoaneurysms may initially be treated without surgery. The three patients with isolated arteriovenous fistulas were followed for two months; all fistulas persisted (did not close spontaneously). It is suggested that symptomatic pseudoaneurysm be treated surgically, especially when associated with large hematomas (blood blisters); asymptomatic pseudoaneurysms usually do not require surgery. Arteriovenous fistulas should be repaired surgically, but a delay of a few weeks is not detrimental. (Consumer Summary produced by Reliance Medical Information, Inc.)