The effects of transfemoral cardiac catheterization on limb blood flow in children

Blood flow was measured with a mercury-in-rubber straingauge plethysmograph in the utilized and intact extrem­ ity during and 24 hours after uncomplicated (with no clinical signs of vascular insufficiency) percutaneous right and left cardiac catheterization in 20 children. In this group, there was a significant decrease of the flow in the utilized extremity after entry into the artery, with the flow returning to normal within 24 hours after the pro­ cedure. Flow was markedly reduced in the utilized ex­ tremity of a child who developed thrombosis of the femoral artery after catheterization. Seven additional children were studied one to four years after retrograde catheterization. In this group the flows in utilized and intact extremities were equal at rest and with reactive hyperemia. It is concluded that uncomplicated transfemoral percutaneous cardiac catheterization in children does not impair the blood flow in the limbs. r F , he percutaneous technique has become increasA ingly popular as a means of cardiac catheter­ ization in children and even in infants since it was introduced by Seldinger 1 in 1953.2 To our knowl­ edge, the effects of this technique on blood flow in the limbs during and after catheterization in chil­ dren have not been reported. Recently, Vyden et al3 reported the effects of transfemoral catheteriza­ tion on blood flow to the lower extremity in 20 adult patients using pneumoplethysmographic studies and concluded that arterial catheterization causes a significant decrease of blood flow in the catheterized extremity lasting at least 24 hours. The purpose of our study was to determine whether percutaneous arterial catheterization in children causes significant changes in blood flow in the limbs during and immediately after catheter­ ization and on a long-term basis. Plethysmographic measurements of blood flow in both utilized and intact extremities during and after transfemoral percutaneous right and left cardiac catheterization were obtained in 20 children. In an additional seven children, studies of flow were done one to four years after retrograde catheterization. MATERIALS AND METHODS