Journal of Cardiology Research and Endovascular Therapy
Iatrogenic Complications During Endovascular Cardiac Interventions: Recognition and Management
Abstract
Muhammet Cihat Celik, Macit Kalcñk, Oguzhan Celik, Osman Karaarslan, Mehmet Mustafa Yñlmaz, Abdullah Sarñhan, Abdulmelik Birgun, Mucahit Yetim, Lutfu Bekar and Yusuf Karavelioglu
Iatrogenic complications remain an inherent risk of endovascular cardiac procedures despite continuous advancements in device technology and procedural techniques. With the expanding use of percutaneous coronary interventions, transcatheter valve therapies, and catheter-based structural interventions, operators increasingly encounter complications related to vascular access, device manipulation, and structural injury. These events, including coronary perforation, vascular disruption, device embolization, and access-site complications, may lead to significant morbidity if not promptly recognized and managed. Contemporary practice has shifted from reliance on emergent surgical conversion toward catheter-based rescue strategies that enable rapid stabilization in many cases. Early recognition through angiographic assessment, hemodynamic monitoring, and adjunctive imaging plays a central role in successful management. Endovascular techniques such as retrieval systems, covered stents, embolization methods, and flow restoration strategies have become essential tools in addressing procedural complications. Mechanical circulatory support may further assist in stabilizing patients with hemodynamic compromise. Identifying procedural and patient-related risk factors, including vascular calcification, large-bore access, and prior surgical interventions, allows for improved procedural planning and complication prevention. A structured approach integrating prevention, rapid diagnosis, and targeted endovascular intervention is critical for optimizing outcomes. This review provides an overview of the mechanisms, predictors, recognition, and contemporary management strategies of iatrogenic complications encountered during endovascular cardiac procedures.