经皮股动脉穿刺的严重并发症

Serious complications of percutaneous femoral artery puncture

目的 :探讨经皮股动脉穿刺的一些严重并发症。方法 :由 2名有经验的介入医师对 48例股动脉穿刺点严重并发症进行共同分析 ,并达成一致意见。结果 :股动脉穿刺严重并发症的发生率为 0 .46% ,其中股动脉血栓 18例( 3 7.5 0 % ) ,股动脉夹层 16例 ( 3 3 .3 3 % ) ,假性动脉瘤 10例 ( 2 0 .83 % ) ,股动脉严重痉挛 2例 ( 4 .17% ) ,股动脉穿破 2例( 4 .17% )。结论 :利用透视指导 ,轻柔的操作 。

Objective:To study the causes of serious complications of percutaneous femoral artery puncture and to explore the methods of reducing the complications.Methods:48 patients with femoral artery complications in 10,500 femoral artery punctures by Seldinger′s technique were reviewed.The causes of complications were analyzed by two experienced interventional radiologists and a consensus interpretation was formed.Results:The total incidence of complications at the puncture site after the procedure was 0.46%.In the 48 cases,the femoral artery thrombus formation occurred in 18 cases (37.50%),dissection in 16 (33.33%),postcatheterization pseudoaneurysm in 10 (20.83%),serious arterial spasm in 2 (4.17%) and tear of femoral artery in 2 (4.17%).The causes of complications might be related to the followings: the puncture site was too low,large diameter sheaths used,fibrinolytic therapy,obesity of the patient,inexperience of operator,and so on.Conclusion:The incidence of complications is low,but injuries at the puncture site may cause serious sequelae.The fluoroscopic guidance,gentle handling,meticulous postoperative observation and rich experience of puncturing are essential for reducing these complications.