Compression ultrasonography for false femoral artery aneurysms: hypocoagulability is a cause of failure.
OBJECTIVE
False femoral artery aneurysm is an occasional complication of percutaneous cardiovascular radiological procedures. Compression ultrasonography causes thrombosis non-invasively, reducing need for operative intervention. The technique fails in a proportion of cases. Analysis was undertaken to identify causes of failure.


METHODS
Prospective open study.


METHODS
Patients presenting with false femoral artery aneurysm since 1984 were identified from a computerised database (BIPAS). Since 1993 compression ultrasonography has been performed as first line treatment according to a standard protocol. Prospectively collected ultrasonographic data and case notes were reviewed to identify causes of failed compression.


RESULTS
False femoral artery aneurysm occurred as a complication in 32/26,687 (0.12%) cardiovascular radiological procedures. Eighteen aneurysms were treated by compression. The technique was successful in 11/18 (61%) cases but primary failure occurred in seven cases. Six out of seven had bleeding abnormalities (Chi-squared analysis with Yates correction 10.55, p = 0.0012), four were anticoagulated and compression was subsequently successful following reversal of warfarin therapy in three of these patients. In 4/18 cases surgical repair was necessary.


CONCLUSIONS
Compression ultrasonography is an effective treatment of false femoral aneurysms, however, hypocoagulability is a significant cause of failure. For patients in whom anticoagulation cannot be reversed, primary surgical repair should be considered.
Lewis
D R
DR
Department of Surgery, Bristol Royal Infirmary, U.K.
Davies
A H
AH
Irvine
C D
CD
Morgan
M R
MR
Baird
R N
RN
Lamont
P M
PM
Smith
F C
FC
D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000628:therapy*; D005263:Femoral Artery / Q000000981:diagnostic imaging; D006801:Humans; D012189:Retrospective Studies; D017211:Treatment Failure; D018616:Ultrasonography, Doppler, Duplex / Q000379:methods*