Thrombus formation after percutaneous catheterization and manual compression of the femoral artery in heparinized sheep

Young Hwan Kim, Dusan Pavcnik, Hideyaki Kakizawa, Barry Uchida, Allen Burke, Marc Loriaux, Frederick Keller, Josef Rosch

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

The purpose of this study was to evaluate the angiographic and histopathologic changes in the superficial femoral artery (SFA) in heparinized sheep shortly after catheterization with an 8-Fr sheath and manual compression hemostasis either with standard manual compression (SMC) or with the use of a procoagulant chitosan-based HemCon Bandage. The evaluation was done in 38 SFAs of 19 heparinized (100 mg/kg) sheep. After a 5-min catheterization with an 8-Fr sheath, a 5-min compression was applied. Follow-up angiograms to evaluate hemostasis were done immediately after release of compression and then at 2.5-min intervals until no extravasation was present. Compression was reapplied between angiograms. Final angiograms were performed approximately 30 min after hemostasis and after 3 min of passive flexion and extension of sheep hind limbs. Sheep were then euthanized and SFA specimens with surrounding tissues excised for histopathologic evaluation. Both types of compression caused similar changes in the catheterized SFAs. Follow-up angiograms showed mild arterial narrowing in 14 SFAs and intraluminal clots in 9 SFAs. Histology revealed periarterial hematoma in all 38 specimens. Intraluminal thrombi consisting predominantly of platelets and fibrin were present in 32 SFAs. Their size varied from superficial elevations (8 arteries) to medium-sized, 1- to 2-mm, polypoid protrusions (15 arteries) to large polypoid clots, 3-4 mm long (9 arteries). In six SFAs, the arterial access sites were not included in the obtained specimens. In conclusion, hemostasis with manual compression is achieved in the acute phase by formation of a predominantly plateletfibrin thrombus occluding the arterial wall access site and often extending significantly into the arterial lumen. The healing process of arterial access sites should be explored several days after catheterization.

Original languageEnglish (US)
Pages (from-to)321-329
Number of pages9
JournalCardioVascular and Interventional Radiology
Volume33
Issue number2
DOIs
StatePublished - Apr 2010

Fingerprint

Femoral Artery
Hemostasis
Catheterization
Sheep
Angiography
Thrombosis
Arteries
Chitosan
Bandages
Fibrin
Hematoma
Histology
Blood Platelets
Extremities

Keywords

  • Arteries
  • Arteriography
  • Catheterization
  • Complications
  • Hemostasis
  • Histopathology
  • Procoagulant
  • Thrombosis

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Thrombus formation after percutaneous catheterization and manual compression of the femoral artery in heparinized sheep. / Kim, Young Hwan; Pavcnik, Dusan; Kakizawa, Hideyaki; Uchida, Barry; Burke, Allen; Loriaux, Marc; Keller, Frederick; Rosch, Josef.

In: CardioVascular and Interventional Radiology, Vol. 33, No. 2, 04.2010, p. 321-329.

Research output: Contribution to journalArticle

@article{735b1278c914456780881214f59de6a0,
title = "Thrombus formation after percutaneous catheterization and manual compression of the femoral artery in heparinized sheep",
abstract = "The purpose of this study was to evaluate the angiographic and histopathologic changes in the superficial femoral artery (SFA) in heparinized sheep shortly after catheterization with an 8-Fr sheath and manual compression hemostasis either with standard manual compression (SMC) or with the use of a procoagulant chitosan-based HemCon Bandage. The evaluation was done in 38 SFAs of 19 heparinized (100 mg/kg) sheep. After a 5-min catheterization with an 8-Fr sheath, a 5-min compression was applied. Follow-up angiograms to evaluate hemostasis were done immediately after release of compression and then at 2.5-min intervals until no extravasation was present. Compression was reapplied between angiograms. Final angiograms were performed approximately 30 min after hemostasis and after 3 min of passive flexion and extension of sheep hind limbs. Sheep were then euthanized and SFA specimens with surrounding tissues excised for histopathologic evaluation. Both types of compression caused similar changes in the catheterized SFAs. Follow-up angiograms showed mild arterial narrowing in 14 SFAs and intraluminal clots in 9 SFAs. Histology revealed periarterial hematoma in all 38 specimens. Intraluminal thrombi consisting predominantly of platelets and fibrin were present in 32 SFAs. Their size varied from superficial elevations (8 arteries) to medium-sized, 1- to 2-mm, polypoid protrusions (15 arteries) to large polypoid clots, 3-4 mm long (9 arteries). In six SFAs, the arterial access sites were not included in the obtained specimens. In conclusion, hemostasis with manual compression is achieved in the acute phase by formation of a predominantly plateletfibrin thrombus occluding the arterial wall access site and often extending significantly into the arterial lumen. The healing process of arterial access sites should be explored several days after catheterization.",
keywords = "Arteries, Arteriography, Catheterization, Complications, Hemostasis, Histopathology, Procoagulant, Thrombosis",
author = "Kim, {Young Hwan} and Dusan Pavcnik and Hideyaki Kakizawa and Barry Uchida and Allen Burke and Marc Loriaux and Frederick Keller and Josef Rosch",
year = "2010",
month = "4",
doi = "10.1007/s00270-009-9688-2",
language = "English (US)",
volume = "33",
pages = "321--329",
journal = "CardioVascular and Interventional Radiology",
issn = "7415-5101",
publisher = "Springer Verlag",
number = "2",

}

TY - JOUR

T1 - Thrombus formation after percutaneous catheterization and manual compression of the femoral artery in heparinized sheep

AU - Kim, Young Hwan

AU - Pavcnik, Dusan

AU - Kakizawa, Hideyaki

AU - Uchida, Barry

AU - Burke, Allen

AU - Loriaux, Marc

AU - Keller, Frederick

AU - Rosch, Josef

PY - 2010/4

Y1 - 2010/4

N2 - The purpose of this study was to evaluate the angiographic and histopathologic changes in the superficial femoral artery (SFA) in heparinized sheep shortly after catheterization with an 8-Fr sheath and manual compression hemostasis either with standard manual compression (SMC) or with the use of a procoagulant chitosan-based HemCon Bandage. The evaluation was done in 38 SFAs of 19 heparinized (100 mg/kg) sheep. After a 5-min catheterization with an 8-Fr sheath, a 5-min compression was applied. Follow-up angiograms to evaluate hemostasis were done immediately after release of compression and then at 2.5-min intervals until no extravasation was present. Compression was reapplied between angiograms. Final angiograms were performed approximately 30 min after hemostasis and after 3 min of passive flexion and extension of sheep hind limbs. Sheep were then euthanized and SFA specimens with surrounding tissues excised for histopathologic evaluation. Both types of compression caused similar changes in the catheterized SFAs. Follow-up angiograms showed mild arterial narrowing in 14 SFAs and intraluminal clots in 9 SFAs. Histology revealed periarterial hematoma in all 38 specimens. Intraluminal thrombi consisting predominantly of platelets and fibrin were present in 32 SFAs. Their size varied from superficial elevations (8 arteries) to medium-sized, 1- to 2-mm, polypoid protrusions (15 arteries) to large polypoid clots, 3-4 mm long (9 arteries). In six SFAs, the arterial access sites were not included in the obtained specimens. In conclusion, hemostasis with manual compression is achieved in the acute phase by formation of a predominantly plateletfibrin thrombus occluding the arterial wall access site and often extending significantly into the arterial lumen. The healing process of arterial access sites should be explored several days after catheterization.

AB - The purpose of this study was to evaluate the angiographic and histopathologic changes in the superficial femoral artery (SFA) in heparinized sheep shortly after catheterization with an 8-Fr sheath and manual compression hemostasis either with standard manual compression (SMC) or with the use of a procoagulant chitosan-based HemCon Bandage. The evaluation was done in 38 SFAs of 19 heparinized (100 mg/kg) sheep. After a 5-min catheterization with an 8-Fr sheath, a 5-min compression was applied. Follow-up angiograms to evaluate hemostasis were done immediately after release of compression and then at 2.5-min intervals until no extravasation was present. Compression was reapplied between angiograms. Final angiograms were performed approximately 30 min after hemostasis and after 3 min of passive flexion and extension of sheep hind limbs. Sheep were then euthanized and SFA specimens with surrounding tissues excised for histopathologic evaluation. Both types of compression caused similar changes in the catheterized SFAs. Follow-up angiograms showed mild arterial narrowing in 14 SFAs and intraluminal clots in 9 SFAs. Histology revealed periarterial hematoma in all 38 specimens. Intraluminal thrombi consisting predominantly of platelets and fibrin were present in 32 SFAs. Their size varied from superficial elevations (8 arteries) to medium-sized, 1- to 2-mm, polypoid protrusions (15 arteries) to large polypoid clots, 3-4 mm long (9 arteries). In six SFAs, the arterial access sites were not included in the obtained specimens. In conclusion, hemostasis with manual compression is achieved in the acute phase by formation of a predominantly plateletfibrin thrombus occluding the arterial wall access site and often extending significantly into the arterial lumen. The healing process of arterial access sites should be explored several days after catheterization.

KW - Arteries

KW - Arteriography

KW - Catheterization

KW - Complications

KW - Hemostasis

KW - Histopathology

KW - Procoagulant

KW - Thrombosis

UR - http://www.scopus.com/inward/record.url?scp=77953134785&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77953134785&partnerID=8YFLogxK

U2 - 10.1007/s00270-009-9688-2

DO - 10.1007/s00270-009-9688-2

M3 - Article

C2 - 19705199

AN - SCOPUS:77953134785

VL - 33

SP - 321

EP - 329

JO - CardioVascular and Interventional Radiology

JF - CardioVascular and Interventional Radiology

SN - 7415-5101

IS - 2

ER -