RESUMO
To assess the efficacy of ultrasound guided compression therapy for the treatment of post catheterization femoral pseudoaneurysms. A retrospective review of 21 patients who underwent ultrasound guided compression for treatment of post catheterization pseudoaneurysm at King Hussein Medical Center / Vascular unit between February 2009 and March 2010 was conducted. Fifteen patients were males and 6 were females with mean age of 62 years. Eight patients had diagnostic catheterization while 13 had interventional cardiac procedures. All patients were diagnosed using Duplex scan and were treated with compression. Analysis of the results, efficacy and safety of the ultrasound guided compression treatment modality were discussed. Successful pseudoaneurysm compression was obtained in 16 patients [76%] whereas 5 patients failed compression and underwent surgical repair. Pseudoaneurysm size ranged between 2.0 -4.5 cm. The mean compression time to accomplish closure was 25 minutes. Two patients required more than one session to get a successful result. Pseudoaneurysm involved the common femoral artery in 8 patients while in 13 patients the origin was distal to the femoral artery bifurcation. All patients were followed up one week after successful compression procedure by a new Duplex scan with no recurrence of pseudoaneurysm and no arterial or venous complications were reported. Ultrasound guided compression for the treatment of post catheterization pseudoaneurysm is an effective alternative to surgical repair. It is non invasive and safe modality with high success rate and low complications. It should be considered as a first line of management of uncomplicated femoral pseudoaneurysms
RESUMO
Of all the paragangliomas in the head and neck, carotid body tumors are the most common. They are rare hyper- vascular neoplastic lesions derived from the neural crest paraganglion cells. In this study, we present our 16 years experience in dealing with this neoplasm. The medical records of 33 patients with 37 surgically treated carotid body tumors between the year 1993 and 2009 at the Vascular Unit of Queen Alia Military Hospital and King Hussein Medical Center were retrospectively reviewed. Twenty patients were females and 13 were males. The mean age was 46 years. All the patients presented with a painless neck mass that was investigated by duplex ultrasound, CT angiogram and arteriography. Two patients had hoarseness of voice and dyspnea, one had dysphagia and one had vertigo. Complete surgical excision was performed in all the patients with close follow-up in respect to complications, recurrence and behavior of the tumor. According to Shamblin Classification, 5 tumors were type I, 22 were type II and 10 were type III confirmed intraoperatively. Four patients had bilateral involvement at the time of presentation. Six patients had positive family history of the tumor. After successful surgical resection, a mean follow-up period of 24 months showed a zero mortality rate and no evidence of recurrence. Transient neuropraxia of the facial nerve was noticed in one patient, injury of recurrent laryngeal nerve in another patient while post operative localized hematoma had to be evacuated in two patients. Although rare, carotid body tumor should be kept in mind in the differential diagnosis of anterior triangle neck mass. Complete surgical excision after adequate investigations is the treatment of choice. This is best achieved in a specialized centre with experienced vascular surgeons to get the finest outcome