Complications and Great Escapes: Equipment and Techniques

Abstract

All endovascular procedures have the potential for complications. The primary aims should always be avoidance of preventable complications and to minimize the impact of any complication. The core principles of an effective preventive strategy are: involving the interventional and clinical teams in a clear outline of the procedure and its potential adverse outcomes; ensuring an adequate inventory of required and backup equipment; the use of “time-out” to minimize wrong patient/wrong side adverse events; and an active audit program to identify areas of improvement. In the event of an adverse outcome there are many strategies that can be employed to rectify the situation or minimize the iatrogenic injury. This article provides a case-based discussion highlighting some of these techniques and how they can be used in a clinical setting.

Keywords

interventional radiology - complications - iliac arterial rupture - iatrogenic arteriovenous fistula - vascular snare - distal embolization - thrombolysis

• References

• 1 Working Party on Thrombolysis in the Management of Limb Ischemia. Thrombolysis in the management of lower limb peripheral arterial occlusion—a consensus document. Am J Cardiol 1998; 81 (2) 207-218
• 2 Davies MG, Bismuth J, Saad WE , et al. Implications of in situ thrombosis and distal embolization during superficial femoral artery endoluminal intervention. Ann Vasc Surg 2010; 24 (1) 14-22
• 3 Kondo Y, Dardik A, Muto A, Koizumi J, Nishibe M, Nishibe T. Primary stent placement for iliac artery chronic total occlusions. Surg Today 2010; 40 (5) 433-439