Duplex-guided compression of iatrogenic femoral pseudoaneurysms.
BACKGROUND
Iatrogenic pseudoaneurysms are a major complication following percutaneous cannulations of the femoral artery. Surgical repair has been the traditional treatment modality. Recent reports have introduced duplex-guided compression as a means of nonoperative management of these injuries. We proposed to determine if duplex-guided compression of femoral pseudoaneurysms could be successfully performed, could be done without complication, and could maintain thrombosis on long-term follow-up.


METHODS
All patients presenting with large groin hematomas following invasive percutaneous femoral artery procedures over a seven-month period were studied using color-flow duplex analysis. Six pseudoaneurysms were discovered and successfully treated with duplex-guided compression. All patients were then followed-up prospectively with both early and long-term repeat duplex analysis.


RESULTS
All patients were rescanned 72 hours later and the pseudoaneurysms remained thrombosed. Upon returning for long-term follow-up examination, patients again had duplex confirmation of thrombosis, with a mean follow-up time of 21 months (range, five to 29 months). No complications attributable to this technique have been noted.


CONCLUSIONS
This study confirms the clinical usefulness of duplex-guided compression in the evaluation and treatment of iatrogenic femoral pseudoaneurysms.
Mooney
M J
MJ
Department of Surgery, Blanchfield Army Community Hospital, Fort Campbell, KY, USA.
Tollefson
D F
DF
Andersen
C A
CA
Kanar
E A
EA
Weiland
C L
CL
D000328:Adult; D000368:Aged; D000783:Aneurysm / Q000000981:diagnostic imaging* / Q000628:therapy*; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging / Q000628:therapy; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000295:instrumentation; D004621:Embolization, Therapeutic; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging* / Q000293:injuries; D005500:Follow-Up Studies; D006406:Hematoma / Q000000981:diagnostic imaging / Q000209:etiology; D006801:Humans; D007049:Iatrogenic Disease; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011312:Pressure; D011446:Prospective Studies; D018615:Ultrasonography, Doppler, Color; D018616:Ultrasonography, Doppler, Duplex; D018084:Ultrasonography, Interventional