Arterial Dissection

  • Dimitrios Tsetis
  • Elias Kehagias
  • Stavros Spiliopoulos
  • Dimitrios Siablis


Percutaneous femoral catheterization is complicated by intimal dissection with or without associated arterial thrombosis in 0.5 % of the cases. Fortunately, in most cases, subintimal passage of the guidewire or catheter is immediately recognized, and another arterial access is selected, or the procedure is postponed; in such an occasion, usually the vessel patency is not compromised. In a minority of cases, the dissected intima can cause severe stenosis or even acute thrombosis of the arterial lumen.

It is not unusual for arterial dissection or thrombosis to be diagnosed only after completion of the endovascular procedure. A possible mechanism explaining the latter is that the guidewire follows a subintimal route with spontaneous re-entry to the true lumen; this extensive vessel injury, in combination with excessively firm external compression applied after sheath removal, may cause a severe obstruction to flow in the iliofemoral region, resulting in acute thrombosis.


Arterial Thrombosis Activate Partial Thromboplastin Time Stent Deployment True Lumen Arterial Dissection 
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  1. 1.
    Samson RH, Sprayregen S, Veith FJ, Scher LA, Gupta SK, Ascer E. Management of angioplasty complications, unsuccessful procedures and early and late failures. Ann Surg. 1984;199:234–40.PubMedCrossRefGoogle Scholar
  2. 2.
    Labropoulos N, Giannoukas AD, Volteas SK, Kutoubi AA. Complications of the balloon assisted percutaneous transluminal angioplasty. J Cardiovasc Surg. 1994;35:475–89.Google Scholar
  3. 3.
    Tsetis DK, Kochiadakis GE, Hatzidakis AA, et al. Transcatheter thrombolysis with high-dose bolus tissue plasminogen activator in iatrogenic arterial occlusion after femoral arterial catheterization. Cardiovasc Intervent Radiol. 2002;25:36–41.PubMedCrossRefGoogle Scholar
  4. 4.
    Youkey JR, Clagett GP, Rich NM, et al. Vascular trauma secondary to diagnostic and therapeutic procedures: 1974 through 1982. A comparative review. Am J Surg. 1983;146:788–91.PubMedCrossRefGoogle Scholar
  5. 5.
    Tsetis D. Endovascular treatment of complications of femoral arterial access. Cardiovasc Intervent Radiol. 2010;33(3):457–68.PubMedCrossRefGoogle Scholar
  6. 6.
    Onal B, Ilgit ET, Akpek S, Erbas G, Akkaya A. Endovascular treatment of obstructive iliac artery dissections. Acta Radiol. 2005;46:359–65.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Dimitrios Tsetis
    • 1
    • 2
  • Elias Kehagias
    • 1
  • Stavros Spiliopoulos
    • 3
  • Dimitrios Siablis
    • 3
  1. 1.Department of Radiology, Interventional Radiology UnitHeraklion University Hospital, School of Medicine CreteHeraklionGreece
  2. 2.Department of Angiography and Interventional Radiology, University Hospital of Heraklion, Faculty of MedicineUniversity of CreteHeraklionGreece
  3. 3.Department of Diagnostic and Interventional RadiologyPatras University Hospital, School of MedicineRioGreece

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