Ultrasound-guided compression of iatrogenic femoral artery pseudoaneurysms

ABSTRACT

From March 2002 to May 2004, forty-two patients with iatrogenic pseudoaneuiysm after diagnostic and interventional procedures were identified by clinical and duplex examination. Data of the patients were collected regarding, clinical picture, catheterization procedure, size of sheath, coagulation parameters, pseudoaneurysm size and location, time to compression, and number of attempts at compression. Patients who had successful ultrasound guided compression underwent follow-up duplex scanning. Forty-two patients with iatrogenic pseudoaneurysms were treated with UGC over a 26-months period. UGC was successful at obliterating the false aneurysm cavity with the initial attempt in 37 [88.1%] patients, in two of these patients [4.8%] recurrence of false aneurysm occurred 3 and 9 days after initially successful UGC. Obliteration of three additional pseudoaneurysms [7.1%] was achieved on subsequent UGC attempts after failure of the initial attempts of UGC. This account for an overall success rate of [95.3%]. Surgical repair was attempted in two [4.8%] patients where UGC was not successful. There were no episodes of thromboembolism or skin necrosis. Follow-up was available for thirty-six patients, for whom physical examination and follow-up duplex was done 1 to 12 months after compression. There was no evidence of late recurrence of pseudoaneurysm, or residual thrombus. Pseudoaneuiysms after iatrogenic arteriographic and interventional procedures can often be successfully compressed with an ultrasound-guided technique. The precise role of this technique would appear to be a valuable method for management of uncomplicated iatrogenic femoral artery pseudoaneurysms