Femoral vascular complications after catheter ablation in the current era: The utility of computed tomography imaging

被引：7

作者：

Ishikawa, Eri ^{[1
]}

Miyazaki, Shinsuke ^{[1
]}

Mukai, Moe ^{[1
]}

Aoyama, Daisetsu ^{[1
]}

Nodera, Minoru ^{[1
]}

Hasegawa, Kanae ^{[1
]}

Kaseno, Kenichi ^{[1
]}

Miyahara, Kosuke ^{[1
]}

Matsui, Akira ^{[1
]}

Shiomi, Yuichiro ^{[1
]}

Tama, Naoto ^{[1
]}

Ikeda, Hiroyuki ^{[1
]}

Fukuoka, Yoshitomo ^{[1
]}

Ishida, Kentaro ^{[1
]}

Uzui, Hiroyasu ^{[1
]}

Tada, Hiroshi ^{[1
]}

机构：

[1] Univ Fukui, Fac Med Sci, Dept Cardiovasc Med, 23-3 Matsuokashimoaizuki, Eiheiji, Fukui 9101193, Japan

来源：

JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY | 2020年 / 31卷 / 06期

关键词：

arteriovenous fistula; catheter ablation; complication; pseudoaneurysm;

D O I：

10.1111/jce.14468

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background Few studies have examined the characteristics of catheter ablation vascular complications, and recently physicians increasingly use computed tomography angiography (CTA) for diagnosing. Objective We sought to investigate the incidence of femoral vascular complications in catheter ablation and factors associated with complications in the current era. Methods This single-center observational study consisted of 311 consecutive (atrial fibrillation, atrial flutter, paroxysmal supraventricular tachycardia, and ventricular arrhythmias in 222 [71.4%], 7 [2.3%], 43 [13.8%], and 39 [12.5%]) patients who underwent catheter ablation. The detailed patient data and clinical outcomes were obtained from the medical records. Results Emergent CTA was performed in a total of 8 (2.6%) patients at a median of 4.5 (2.0-12.5) days postprocedure, and the precise diagnosis was obtained in all. Among them, pseudoaneurysms, arteriovenous fistulae (AVF), and actively bleeding hematomas were identified in two, one, and one patient, respectively, and all required readmissions after discharge. AVF was diagnosed by a Doppler ultrasound examination in another patient. In total, 5 (1.6%) patients exhibited major femoral vascular complications including two pseudoaneurysms, two AVFs, and one active bleeding hematoma. The pseudoaneurysms and AVFs were successfully eliminated by direct compression, and extravasation from the femoral circumflex artery required coil embolization. Antiplatelet therapy and the use of larger arterial sheaths (>= 7-Fr) increased the major femoral arterial complications, but atrial fibrillation ablation under uninterrupted anticoagulation therapy or the use of larger venous sheaths did not. Conclusion Vascular complications are still not negligible procedure-related complications during catheter ablation in the current era. CTA provides a rapid and precise diagnosis for optimal treatment strategies.

引用

页码：1385 / 1393

页数：9

共 11 条

[1] Feasibility of Uninterrupted Direct Oral Anticoagulants with Temporary Switching to Dabigatran ("Dabigatran Bridge") for Catheter Ablation of Atrial Fibrillation [J].