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Incidence and predictors of cardiac catheterisation-related arterial thrombosis in children
  1. Barbara Brotschi1,
  2. Maja I Hug1,
  3. Oliver Kretschmar2,
  4. Mattia Rizzi3,5,
  5. Manuela Albisetti3
  1. 1Division of Intensive Care, University Children's Hospital, Zurich, Switzerland
  2. 2Division of Cardiology, University Children's Hospital, Zurich, Switzerland
  3. 3Division of Hematology, University Children's Hospital, Zurich, Switzerland
  4. 4Children's Research Center, University Children's Hospital, Zurich, Switzerland
  5. 5Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
  1. Correspondence to Dr Manuela Albisetti, Division of Hematology, University Children's Hospital, Steinwiesstrasse 75, Zurich CH-8032, Switzerland; Manuela.albisetti{at}kispi.uzh.ch

Abstract

Objective Arterial thrombosis is one of the most reported complications of cardiac catheterisation (CC) in children. The aim of the study was to evaluate the incidence and predictors of arterial thrombosis in children with cardiac diseases (CDs).

Methods During 12 consecutive months, all children aged 0–19 years undergoing CC of the femoral arteries were included in this observational study. After CC, clinical evaluation of impaired limb perfusion was performed according to local guidelines. Doppler ultrasonography was performed when decreased limb perfusion was suspected.

Results 123 children (30% aged <12 months, 70% aged >12 months) underwent CC. Arterial thrombosis occurred in 14 of the 123 children (11.4%). Twelve cases (12/14=86%) of arterial thrombosis occurred in infants aged <12 months and 2 (2/14=14%) in older children. Overall younger age (p<0.01, OR (95% CI) 0.49 (0.28 to 0.86)) and low body weight (p<0.004, OR (95% CI) 0.78 (0.65 to 0.92)) were significantly associated with an increased risk of arterial thrombosis. Cyanotic CD (p=0.07, OR (95% CI) 2.87 (0.90 to 9.15)) showed a trend towards increased thrombotic risk.

Conclusions Arterial thrombosis is a common complication of CC in infants. Diagnosis of CC-related arterial thrombosis remains a challenge. Well-defined clinical monitoring protocols may be valuable methods for timely detection and treatment of arterial thrombosis.

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