Postcatheterization femoral artery pseudoaneurysms: therapeutic options. A case-controlled study.
OBJECTIVE
Postcatheterization femoral artery pseudoaneurysm is a troublesome complication following percutaneous canulations of the femoral artery. Both diagnostic and therapeutic options in the management of these pseudoaneurysms have changed dramatically, with surgery being required only rarely. We aimed to perform a comprehensive review of our experience, techniques and results in treating postcatheterization femoral artery pseudoaneurysms.


METHODS
A retrospective study of all patients presenting with local complications following invasive percutaneous femoral artery canulations over a five-year period was performed. Physical examination with color Doppler ultrasound analysis identified 29 femoral artery pseudoaneurysms. Surgery, duplex-guided compression, and thrombin injection were the main therapeutic options.


RESULTS
Fourteen cases of femoral artery pseudoaneurysms were treated by duplex-guided compression obliteration with a 78.5% success rate. Four patients had spontaneous thrombosis of their pseudoaneurysms. Five patients underwent percutaneous thrombin injection. Six patients had conventional surgery. Three cases failed duplex-guided compression: one closed with thrombin injection, and two were repaired surgically. Follow-up US showed no recurrent pseudoaneurysms for patients who underwent successful duplex-guided compression.


CONCLUSIONS
Despite the voluminous data in the literature of treating postcatheterization femoral artery pseudoaneurysms by thrombin guided injection, as a quick and effective method of therapy, with infrequent failures and complications, our study confirms the clinical usefulness of duplex-guided compression in the management of these pseudoaneurysms. The possibility of spontaneous thrombosis of small pseudoaneurysms is emphasized.
Heis
Hussein A
HA
Department of Surgery, King Abdullah University Hospital, Faculty of Medicine, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan.
Bani-Hani
Kamal E
KE
Elheis
Mwaffaq A
MA
Yaghan
Rami J
RJ
Bani-Hani
Bayan K
BK
D000328:Adult; D000368:Aged; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy*; D000925:Anticoagulants / Q000627:therapeutic use; D016022:Case-Control Studies; D002406:Catheterization, Peripheral / Q000009:adverse effects*; D000077144:Clopidogrel; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging; D006489:Hemostatic Techniques; D006490:Hemostatics / Q000627:therapeutic use; D006801:Humans; D007269:Injections, Intra-Arterial; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D012189:Retrospective Studies; D013917:Thrombin / Q000627:therapeutic use; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D018615:Ultrasonography, Doppler, Color; D018084:Ultrasonography, Interventional
D000925:Anticoagulants; D006490:Hemostatics; D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013917:Thrombin; D013988:Ticlopidine