Arterial Recanalization for Access for Arterial Intervention in Children: Techniques and Outcomes

J Vasc Interv Radiol. 2018 Oct;29(10):1410-1414. doi: 10.1016/j.jvir.2018.06.001. Epub 2018 Aug 31.

Abstract

Purpose: To assess technical success of arterial recanalization in children requiring repeated arterial access and intervention.

Materials and methods: Over 14 years, 41 attempts to cross 30 arterial occlusions were made in 22 patients (13 male, 9 female). Median patient age was 12 months (15 days-14 years), and weight was 7.6 kg (3.0-77.3 kg). Techniques and outcomes were recorded.

Results: Twenty-five of 41 (61%) attempts at crossing an arterial occlusion were successful. Nineteen of 30 (63%) first attempts to cross occlusions were successful, and 6 of 11 (55%) repeat attempts were successful. The occluded segments were combinations of common femoral artery (n = 4), external iliac artery (n = 36), common iliac artery (n = 11), and aorta (n = 1). Complications occurred in 5 of 41(12%) attempts: 3 minor complications (hematoma, extravasation, and transient leg ischemia) and 2 major complications (rupture and thrombosis).

Conclusions: Arterial access by recanalization of occluded segments is technically feasible in children, with a low complication rate.

MeSH terms

  • Adolescent
  • Age Factors
  • Angiography, Digital Subtraction / adverse effects
  • Angiography, Digital Subtraction / methods*
  • Arterial Occlusive Diseases / diagnostic imaging
  • Arterial Occlusive Diseases / etiology
  • Arterial Occlusive Diseases / physiopathology
  • Arterial Occlusive Diseases / therapy*
  • Catheterization, Peripheral / adverse effects
  • Catheterization, Peripheral / methods*
  • Child
  • Child, Preschool
  • Endovascular Procedures / adverse effects
  • Endovascular Procedures / methods*
  • Feasibility Studies
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Punctures
  • Retrospective Studies
  • Risk Factors
  • Treatment Outcome
  • Vascular Patency