Clinical Sequelae from Arterial Needle Puncture, Cannulation, and Incision

Abstract

A study of 3,193 arterial entries of various types disclosed 66 major complications and 321 minor complications for a total complication rate of 13%. The Seldinger technique of percutaneous arterial catheterization was followed by the highest incidence of complications, the percutaneous needle puncture method was associated with an intermediate complication rate, and the cutdown arteriotomy with suture repair resulted in the lowest complication rate. Utilizing the brachial artery as the entry site resulted in a significantly higher complication rate than utilizing other sites for entering the arterial tree did. Factors significantly increasing the risk of arterial entry include the existence of aortic valvular incompetence in the patient, systemic anticoagulation at the time of the arterial entry, and the presence of arteriosclerosis or hypertension in the patient.