Arterial recanalization for access for arterial intervention in children: techniques and outcomes

Purpose: To assess technical success of arterial recanalization in children requiring repeated arterial access and intervention. Materials and Methods: Over 14 years, 41 attempts to cross 30 arterial occlusions were made in 22 patients (13 male, 9 female). Median patient age was 12 months (15 days–14 years), and weight was 7.6 kg (3.0–77.3 kg). Techniques and outcomes were recorded. Results: Twenty-five of 41 (61%) attempts at crossing an arterial occlusion were successful. Nineteen of 30 (63%) first attempts to cross occlusions were successful, and 6 of 11 (55%) repeat attempts were successful. The occluded segments were combinations of common femoral artery (n = 4), external iliac artery (n = 36), common iliac artery (n = 11), and aorta (n = 1). Complications occurred in 5 of 41(12%) attempts: 3 minor complications (hematoma, extravasation, and transient leg ischemia) and 2 major complications (rupture and thrombosis). Conclusions: Arterial access by recanalization of occluded segments is technically feasible in children, with a low complication rate.