Iran J Pediatr. 2019 October; 29(5):e91965. Published online 2019 October 9. doi: 10.5812/ijp.91965. Research Article Arterial and Venous Complications Early After Cardiac Catheterization in Children and Adolescents: A Prospective Study Hamid Amoozgar 1 , Amir Naghshzan 1 , Mohammad Reza Edraki 1, 2, * , Hamed Jafari 3 , Gholam Hossein Ajami 4 , Hamid Mohammadi 1 , Nima Mehdizadegan 4 , Mohammad Borzouee 4 and Kambiz Keshavarz 4 1 Cardiac Research Center, Shiraz University of Medical Sciences, Shiraz, Iran 2 Pediatric Cardiology Ward, Shiraz University of Medical Sciences, Shiraz, Iran 3 Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran 4 Neonatal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran * Corresponding author: Pediatric Cardiology Ward, Shiraz University of Medical Sciences, Shiraz, Iran. Email: edrakidr@yahoo.com Received 2019 April 04; Revised 2019 May 17; Accepted 2019 August 09. Abstract Objectives: This prospective study was designed with the aim to evaluate the prevalence and risk factors of arterial and venous complications among children and adolescents during cardiac catheterization. Methods: All patients younger than 18 years who underwent cardiac catheterization from April 2016 to April 2017 were consecutively enrolled in this study. Results: A total of 179 vascular accesses were performed, and most (70%) cases were interventional procedures. Totally 17 (14%) arterial and 16 (13%) venous events occurred, while 4% and 5% of them, respectively, were more serious. Half of the patients who underwent axillary artery access developed major or minor trauma, and these subtracted from total events of artery accesses, only 9% of femoral arteries developed minor or major complications. The more serious arterial complications were dissection, pseudo-aneurysm and fistula whereas in venous access they were pseudo-aneurysm and thrombosis. Serious and non-serious complications considered together, the mean age of those without complication was 1.9 ± 3.6 years and in complicated group it was 1.7 ± 2.6 years (P = 0.33), and the mean weight of non-complicated cases was 9.27 ± 7.9 kg and 8.51 ± 8.12 kg in the complicated group with no significant difference (P = 0.41), whereas the incidence of more serious vascular complications was highest among patients younger than 1 year of age, and less than 9 kilograms. 23% of the cases who underwent more than 3 tries for arterial and 100% for venous access showed the complications. Also few arterial tries resulted in unintentional venous complications and vice versa. None of the cases needed surgical or interventional therapy. Conclusions: Our study showed that venous complications are as high as arterial complications, although most of them are self- limited. Keywords: Cardiac Catheterization, Congenital Heart Disease, Arterial Injury, Venous Injury, Children 1. Background Cardiac catheterization (CC) is a mainstay of diagno- sis and treatment of many children with congenital and acquired cardiovascular diseases. Due to their invasive nature, both therapeutic and diagnostic CC is associated with vascular risks and complications, including pseudo- aneurysm, arteriovenous fistula, hematoma, transient loss of pulse, thrombosis, and vessel occlusion (1-8). Indeed the most frequent and relevant complications in childhood af- ter CC are vascular injuries (1, 2). There are several risk factors regarding these compli- cations such as lower weight, longer duration of cannula- tion, larger catheter diameter, cyanosis and arterial access (6-11). Vessel thrombosis after CC might jeopardize future di- agnostic or interventional cardiac procedures. Physical ex- amination is the initial method to evaluate post catheter- ization complications at the site of vascular access, but some injuries are subtle and subclinical, which are not rec- ognizable by physical examination; hence, color Doppler ultrasound can be a useful and reliable noninvasive tool for diagnosis and exclusion of vessel complications even in young children (1). 2. Objectives The aim of this study was to determine prevalence and risk factors of the arterial and venous complications early Copyright © 2019, Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.