Ultrasound guided compression therapy in 134 patients with iatrogenic pseudo-aneurysms: advantage of routine duplex ultrasound control of the puncture site following transfemoral catheterization.
BACKGROUND
The following study was designed to evaluate the effectiveness and safety of ultrasound guided compression therapy (UGCT) of iatrogenic postcatheterization pseudo-aneurysms (PA) on the one hand and to justify the usefulness of the routine colour duplex control of the puncture site following transfemoral catheterization, on the other hand.


METHODS
During the study period 142 patients with (PA) following transfemoral catheterization were identified by means of colour duplex examination Eighty of these 142 patients were identified during a routine colour duplex control of the puncture site the day after PTA/angiography because of peripheral arterial occlusive disease (PAOD) [group A]; the remaining 62 patients with symptomatic groins were referred from other departments [group B].


RESULTS
In 8 patients of group B UGCT was considered to be contra-indicated, they were primarily treated by surgical repair of the PA. A total of 134 patients (group A 80 patients, group B 54 patients) underwent an UGCT. In total the success rate of UGCT was in group A 100% and in group B 78%. 12/54 patients (all group B) with failure of UGCT underwent a secondary surgical repair of the PA. Within group B there was a negative correlation between delay of diagnosis/UGCT and success (p < 0.04), whereas the size of the sheath did not influence the outcome of the UGCT (p = 0.3).


CONCLUSIONS
Our study confirms the effectiveness and safety of UGCT. Routine colour duplex control of the puncture site the day following the removal of the sheath after percutaneous catheterization and UGCT of PAs without delay can increase the success rate of UGCT and minimize the need for surgical repair of PAs.
Ugurluoglu
A
A
Department of Medical Angiology, University of Vienna.
Katzenschlager
R
R
Ahmadi
R
R
Atteneder
M
M
Koppensteiner
R
R
Lang
G
G
Maca
T
T
Minar
E
E
Schneider
B
B
Stümpflen
A
A
Ehringer
H
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000628:therapy*; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging / Q000628:therapy*; D002406:Catheterization, Peripheral / Q000295:instrumentation*; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000293:injuries*; D006406:Hematoma / Q000000981:diagnostic imaging / Q000628:therapy; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male; D008875:Middle Aged; D011312:Pressure; D011677:Punctures; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color / Q000295:instrumentation*