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Arterial Dissection

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

Abstract

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.

Keywords

Arterial Thrombosis Activate Partial Thromboplastin Time Stent Deployment True Lumen Arterial Dissection 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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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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