Author/Editor		Kanič, Vojko; Naji, Franjo; Bombek, Marko
Title		Periferni žilni zapleti po perkutanih žilnih posegih
Type		članek
Source		In: Blinc A, Kozak M, Šabovič M, editors. Slikovne metode v odkrivanju in zdravljenju žilnih bolezni. Letno srečanje Združenja za žilne bolezni SZD; 2005 maj; Ljubljana. Ljubljana: Združenje za žilne bolezni,
Publication year		2005
Volume		str. 39-48
Language		slo
Abstract		Invasive diagnostic and therapeutic procedures are of increasing importance in management of patients with cardiovascular diseases. The common femoral artery is the most common access site to arterial vascular system, less frequently the radial or axillary artery is used. Vascular access site complications after sheath removal were found in approximately one fifth of patients undergoing percutaneus transluminal angiography. Local bleeding, hematoma, pseudoaneurysm or arteriovenous fistula are most commonly found. Other complications, including infection, retroperitoneal hematoma, arterial trombosis and acute groin ischemia are much less frequent. Numerous demographic, procedural and pharmacological factors have been identified as risk predictors for vascular access site complications. With the progress of therapeutic interventional procedures the use of aggressive antiplatelet drugs, anticoagulation treatment and large diameter sheaths may result in increased risk of their occurence. In addition to physical examination, which is quite reliable method for detecting complications, Doppler colour flow imaging is currently believed to be a method of choice for their recognition. Minor complications are usually treated with manual compression or Doppler color flow guided external compression. For major complications, surgical repairis usually needed. In addition to manual compression as the classical method for closure of puncture site after sheath removal, there is an increasing number of vascular closure devices. Besides earlier passive mechanical devices, that were only a substitute for manual compression, systems that provide immediate hemostasis are being developed. There is no convincing evidence yet about reducing the incidence of vascular complications using systems for immediate hemostasis. Further prospective randomized studies are needed to evaluate the effectiveness of different closure devices and economical benefit of their use.
Descriptors		CATHETERIZATION, PERIPHERAL CATHETERS, INDWELLING HEMATOMA ANEURYSM, FALSE ARTERIOVENOUS FISTULA ISCHEMIA INFECTION RADIAL ARTERY BRACHIAL ARTERY