ABSTRACT
Objectives: to evaluate the ultrasound guided compression therapy as a modality of treating femoral false aneurysm in patients post cardiac catheterization and identify factors that affect its technical success
Methods: this is a retrospective study conducted at the vascular surgery department at King Hussein Medical Center in Amman -Jordan during the period of December 2012 and March 2015. Eighty five patients were enrolled in the study, being referred from cardiology clinic at Queen Alia Heart Institute in Amman with femoral false aneurysms post cardiac catheterization. Using duplex ultrasound system transducer arrays, Ultrasound guided compression therapy in our vascular surgery laboratory was used to treat these patients femoral false aneurysms. We have collected and analyzed the specific data regarding false aneurysms anatomic and morphologic characteristics and patients related factors, and evaluate their effect on the success of treatment
Results: over 28 month time period, 85 patients with femoral false aneurysms were treated using ultrasound guided compression therapy. Successful compression of the false aneurysm and complete thrombosis of the sac was achieved in 65 patients [76.47%]. While in 20 patients [34.48 %] ,the procedure was unsuccessful after three attempted trials. Failed compression was reported in 6 patients [ 7 % ] in the first session of compression, who succeeded compression in the second session trial of compression therapy. Among the patient group who failed compression after three trials, 65 % of patients had false aneurysm originated from superficial femoral artery and 3 % had false aneurysm raised from the profunda femoris artery, While 91 % of the patients who succeeded compression had false aneurysm raised from the main common femoral artery. The size of the false aneurysm also affected ultrasound compression sequel, with 40 % of the failed group had size of false aneurysm more than 3.5cm. We had experience one patient with complicated rupture of false aneurysm during the procedure and no patient who succeeded compression had recurrence in the follow up period
Conclusion: among the therapeutic modalities of treating femoral false aneurysm post cardiac catheterization, ultrasound guided compression therapy is considered an effective and safe modality; it has a high success rate with few complications. Several factors decreased the efficacy of the procedure including large size of the false aneurysm and site of origin being not in the common femoral artery
ABSTRACT
To assess the cardiovascular responses induced by different nasal adrenaline-lignocaine mixtures infiltrations protocols for patients undergoing septorhinoplasty under general anesthesia. Our prospective investigation enrolled 212 subjects, aged 26-34 yrs, classified as physical status class one by the American Society of Anesthesiologists [ASAI], of both sexes and scheduled for septorhinoplasty under general endotracheal anesthesia during the period from January 2010 to December 2012, at the King Hussein Hospital, King Hussein Medical Centre, Amman, Jordan. Patients were divided randomly into three groups. Patients in group A [n=70] received nasal sub mucosal infiltration of 10.2 ml of lignocaine 1% [10 mg/ml] with adrenaline 0.0025% [25 mcg/ml]. Subjects in group B [n=72] received 10.2 ml of lignocaine 1% with adrenaline 0.00125% [12.5 mcg mg/ml], while subjects in group C [n=70] received 10.2ml of lignocaine 1% with adrenaline 0.000625% [6.25 mcg/ml]. Cardiovascular parameters including heart rate, systolic blood pressure and mean arterial pressure were recorded every half minute during the first 5 minutes after nasal infiltration. Inter-group statistical comparisons were performed using ANCOVA and intra-group statistical comparisons were achieved using ANOVA. In comparison with baseline readings, heart rate was mostly increased, systolic blood pressure was mostly decreased and mean arterial pressure was mostly reduced significantly [P<0.05] at 60 seconds time interval post infiltration in all three groups. Local nasal sub mucosal infiltration of different adrenaline concentrations containing lignocaine solutions could increase heart rate and reduce mean arterial pressure during the first five minutes after infiltration.