[Treatment of post-coronarography femoral false aneurysm by compression, guided by Doppler echography].
METHODS
We evaluated the role of color Doppler US-guided compression in the non-invasive treatment of femoral artery pseudoaneurysms after cardiac catheterization, including 22 PTCA procedures. The diagnosis of 32 pseudoaneurysms in 32 patients was accomplished by detection of the typical US-Doppler pattern consisting of the swirling color Doppler flow and the "to and fro" pulsed Doppler waveform at a mean 3.6 days (1 to 14) after the cardiac catheterization. Thirteen patients had multiple cavity pseudoaneurysms (2 to 4). All the patients immediately underwent compression therapy.


RESULTS
Treatment was successful in 42/49 cavities (86%) and 25/32 patients (78%), usually after 1 to 3 compression cycles of 6 to 8 minutes duration. Only one recurrence was noted at the 24 hour US-Doppler follow-up. In all cases, pain relief during compression was an excellent clinical sign of hemostatic plug formation and conversion from pseudoaneurysm to simple hematoma. Failures occurred among patients under high dose anticoagulants in spite of 4 to 10 compression cycles.


CONCLUSIONS
In conclusion, color Doppler US-guided compression of post-cardiac catheterization pseudoaneurysms should be the first line therapeutic modality, even in cases of multiple cavities and among patients under effective anticoagulation therapy.
Naïmi
A
A
Département de Radiologie, Hôpital Cantonal Universitaire de Genève, Suisse.
Didier
D
D
Grossholz
M
M
Camenzind
E
E
Chatelain
P
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects; D006328:Cardiac Catheterization / Q000009:adverse effects; D017023:Coronary Angiography / Q000009:adverse effects*; D005260:Female; D005263:Femoral Artery / Q000293:injuries*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018615:Ultrasonography, Doppler, Color
Traitement des faux-anévrismes fémoraux post-coronarographie par compression guidée par échographie-doppler.