Accessing Femoral Arteries Less than 3  mm in Diameter is Associated with Increased Incidence of Loss of Pulse Following Cardiac Catheterization in Infants

AbstractTo evaluate whether avoidance of a risk factor associated with loss of pulse (LOP) following femoral artery (FA) catheterization in infants identified from previous study, was associated with decreased incidence of LOP during a prospective evaluation. Since initiation of routine ultrasound guided femoral arterial access (UGFAA) for infants undergoing catheterization in Jan 2003 –Dec 2011 (Period-1), our incidence of LOP had stayed steady. Prospective evaluation between Jan 2012–Dec 2014 (Period-2), identified FA-diameter <  3 mm as risk factor for LOP. Between Jan 2015–Dec 2018 (Period-3), an initiative to avoid UGFAA for FA-diameter <  3 mm was implemented to determine whether that led to a decreased incidence of LOP. FA-diameter was measured prior to USGFAA and ratio of outer diameter of arterial sheath to luminal diameter of cannulated artery (OD/AD ratio) was calculated during Periods-2 and 3. The incidence and risk factors for LOP were assessed during the three periods. FA-access rates dropped significantly during Period-3 (56.7% vs. 93.8% and 90.4% during Periods-1 and 2, respectively,p <  0.001). Incidence of LOP in Period-3 decreased to 2.7% compared to 12.5% (Period-1) and 17.4% (Period-2) (p <  0.001). By multivariate analysis, FA size <  3 mm and an OD/AD ratio >  40% were the only significant independent predictors for LOP (OR 6.48, 95% CI 2.3–11.42,p <  0.001 and OR 4.16, 95% CI 1.79–8.65,p &...
Source: Mammalian Genome - Category: Genetics & Stem Cells Source Type: research