Management of major XXXX complications of umbilical artery catheters.

@entity1 @entity548 @entity63 @entity1031 @entity272 @entity432
Over the last 9 yr approximately 4000 @entity1 have had physiologic monitoring with UAC at Vanderbilt University Medical Center. A larger number of them had minor @entity63 complications prompting removal of the catheter, but 41 @entity1 had major @entity1031 requiring varying degrees of surgical management. The place of surgery is clear in @entity1 with @entity548 due to vascular avulsion related to catheter removal. @entity1 with @entity432 may be treated expectantly although significant @entity272 may occur. Occlusions at the femoral level allow limb survival, but the long-term outlook is not known; perhaps these @entity1 may better be subjected to femoral thrombectomy in the future. Peripheral pulses are not normal early and Doppler studies suggest that collateral circulation is responsible for limb survival. Whether this will be sufficient to support adequate limb growth and function remains to be seen. @entity1 with signs of aortoiliac or @entity432 should be rapidly investigated and operated upon if survival is to be obtained. This study suggests that an aggressive surgical approach is in order. Computer-assisted radionuclide flow studies are helpful in diagnosing major @entity432 , as well as for followup.
