Expanded indications for the treatment of postcatheterization femoral pseudoaneurysms with ultrasound-guided compression.
BACKGROUND
The purpose of this study was to define the factors that predict successful ultrasound-guided compression repair (UGCR) of postcatheterization femoral pseudoaneurysms (PA) and to determine risks for recurrence, the most appropriate follow-up, and the optimal management of compression failures and recurrences.


METHODS
A retrospective chart review was made.


RESULTS
UGCR thrombosed 52 of 60 PA (87%). Predictors of compression failure were PA size of 8 cm and an associated arteriovenous fistula (AVF). AVF was the only predictor of recurrence. All seven recurrences (13%) were discovered on the first follow-up scan. Four were thrombosed with additional UGCR. Late rescanning after a mean of 264 days identified no recurrences. Four anticoagulated patients failed initial UGCR but were thrombosed in another session when their anticoagulation was briefly reversed.


CONCLUSIONS
UGCR should be the initial management of PA because it is safe, effective, and durable. Temporary discontinuation of anticoagulation and multiple prolonged compression sessions may help treat recalcitrant cases. One follow-up scan is adequate for most patients. Recurrences should be initially treated with repeat UGCR.
Kumins
N H
NH
Division of Vascular Surgery, University of Illinois, Chicago, USA.
Landau
D S
DS
Montalvo
J
J
Zasadzinski
J
J
Wojciechowski
J
J
Jovanovich
B D
BD
Dunn
T B
TB
Baraniewski
H
H
Schuler
J J
JJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D002404:Catheterization / Q000009:adverse effects*; D003627:Data Interpretation, Statistical; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D013997:Time Factors; D018616:Ultrasonography, Doppler, Duplex