Vascular injuries resulting from arterial puncture or catheterization

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Abstract
Diagnostic puncture or catheterization is probably the commonest cause of serious arterial injury in current civilian surgical practice. The most frequent complications are arterial thrombosis, bleeding from the puncture site, false and arteriovenous aneurysm formation, and cerebral embolism. Eight instances of arterial occlusion have been treated in one hospital in less than 18 months–1 followed arterial puncture, 3 followed operative insertion of catheters maintained for repeated blood-sampling, I followed Seldinger catheterization for arteriography, and 3 followed cardiac catheter studies–during which time 1400 such procedures were carried out. Arterial spasm and trauma, large catheter size, protracted catheter maintenance, and low cardiac output seem to be factors particularly liable to produce sufficient damage to precipitate complications, together with thrombosis consequent to sustained heavy local pressure to arrest haemorrhage from the site of arterial puncture. Early surgical correction was successful on each of 6 occasions, but in the 2 cases in which procrastination had occurred major arm amputations became necessary.