PB0267 - Predictors of Catheter-related Arterial Thrombosis in Pediatric Patients After Cardiac Catheterization

Background: Cardiac catheterization is one of the important modalities for diagnosis and treatment in patients with congenital heart disease. Femoral artery thrombosis is the most frequent complication after this procedure. Previous several studies reported that some biomarkers including D-dimer, thrombin-antithrombin complex (TAT), factor VIII clotting activity (FVIII:C) and microparticles could predict vascular thrombosis.

Aims: This study was to determine the association between biomarkers and vascular thrombosis in pediatric patients after cardiac catheterization. Also, it was to determine the risk factors for vascular thrombosis after cardiac catheterization.

Methods: Seventy-five consecutive patients with weight of more than 8 kg and age between 6 months and 18 years old who underwent cardiac catheterization during June 2020 - September 2021 were evaluated. Patients who stopped taking warfarin less than 48 hours or who had arterial and venous thrombosis at lower limbs before the catheterization were excluded. Blood tests for biomarkers and Doppler ultrasound were performed before and 24 hours after the cardiac catheterization.

Results: Seventy-five patients (37 male) were classified into two groups: thrombosis and non-thrombosis group. Five patients were identified to have the femoral artery thrombosis using the Doppler ultrasound. Patients with femoral artery thrombosis were age < 5.7 years, weight < 11.5 kg, procedure time > 70 minutes, and size of sheath/BSA > 9.3. In multivariate logistic regression analysis, weight < 11.5 kg was the only significant risk factor for femoral artery thrombosis [odd ratio 10.9 (95%CI 1.1-108.6)]. However, biomarkers including D-dimer, TAT, FVIII:C, and microparticles were not statistically significantly different between the two groups at the pre-and post-cardiac catheterization.

Conclusion(s): The biomarkers including D-dimer, TAT, FVIII, and microparticles could not predict arterial thrombosis after cardiac catheterization. The patients with weight < 11.5 kg were a significant risk factor for femoral artery thrombosis.