Document Detail


Brachial artery damage following cardiac catheterisation. When to re-explore.
MedLine Citation:
PMID:  2191874     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Cardiac catheterisation is frequently performed in modern medical practice and the brachial artery is frequently used. The brachial and forearm systolic pressures were measured by Doppler ultrasound at rest and after hand exercise for 60 s in 75 patients undergoing catheterisation. These objective measurements, together with a history of forearm claudication during the one minute of exercise and clinical examination of the radial pulse were repeated again at 1 hour, 1 week and 3 months. Changes in the forearm/brachial pressure index (PI) at rest and a fall in forearm pressure after exercise were compared with the pre-catheterisation values. Sixteen per cent of patients suffered claudication of the forearm during the one minute hand exercise immediately after catheterisation. Of those seen at 3 months, 12% had persistent claudication and all had a markedly reduced PI measured following catheterisation. Conversely, at 1 [corrected] hour after catheterisation, the radial pulse was weak or absent in 20% and 33% were abnormal on Doppler studies and not all had symptoms. It emerges that to avoid claudicating forearms at 3 months, re-exploration, one hour after brachial catheterisation is indicated in some cases. We are inclined to base this upon the 16% who had forearm claudication after one minute of exercise and who also had absent or reduced radial [corrected] pulse and abnormal Doppler studies. Conversely to base the need for re-exploration upon a reduction or absence of the radial pulse [corrected] (20%) on Doppler studies (33%) would lead to an unnecessarily high rate of re-exploration just after the procedure.
Authors:
J Walton; R M Greenhalgh
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of vascular surgery     Volume:  4     ISSN:  0950-821X     ISO Abbreviation:  Eur J Vasc Surg     Publication Date:  1990 Jun 
Date Detail:
Created Date:  1990-07-20     Completed Date:  1990-07-20     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8709440     Medline TA:  Eur J Vasc Surg     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  219-22     Citation Subset:  IM    
Affiliation:
Department of Surgery, Charing Cross Hospital, London, U.K.
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MeSH Terms
Descriptor/Qualifier:
Arterial Occlusive Diseases / diagnosis,  etiology*
Blood Pressure / physiology
Blood Pressure Determination / methods
Brachial Artery / injuries*,  physiology
Exercise Test
Follow-Up Studies
Forearm / blood supply
Heart Catheterization / adverse effects*
Humans
Reoperation
Time Factors
Ultrasonography
Comments/Corrections
Erratum In:
Eur J Vasc Surg 1990 Aug;4(4):following 442

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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