title: Iatrogenic femoral pseudoaneurysms - a simple solution of inconvenient problem?
abstract: OBJECTIVE
  A femoral artery pseudoaneurysm - is the most common complication associated with invasive coronary interventions. The aim of the study was to analyze the effectiveness of various methods used for femoral pseudoaneurysm treatment and to assess how routine use of radial approach leads to reduction of these site complications.
  
  
  METHODS
  The study comprised 1854 consecutive patients who were hospitalized in years 2005-2008 and underwent coronary angiography (with or without angioplasty) via femoral artery access. Since 2009 routine radial approach has been introduced for both coronary angiography and angioplasty. In patients with symptoms suggesting entry site complications Doppler ultrasound was performed.
  
  
  RESULTS
  Femoral access site complications requiring additional procedures were observed in 63 patients (3.4%): in 56 femoral pseudoaneurysms (88.8%) and in 7 arteriovenous fistulas (11.1%) were diagnosed (all appeared after coronary angioplasty). The patients were treated in following ways: standard compression with an elastic bandage prolonged to 12 hours - in 14 cases (25%), ultrasound guided compression - in 13 patients (23.2%), finger compression followed by standard compression with an elastic bandage prolonged to 12 hours or ice compress - in 10 patients (17.8%), surgical treatment - in 3 patients (5.3%). Only 2 patients required thrombin injection (3.6%). Since the time routine radial approach was introduced extreme reduction in the rate of local complications was registered.
  
  
  CONCLUSIONS
  Although iatrogenic femoral pseudoaneurysms following invasive percutaneous coronary interventions are still important complications, most of them can be treated conservatively. It seems that radial access completely eliminates the risk of this complication.
authors: Department of Cardiology, Medical University of Bialystok, Bialystok, Poland. anlila@poczta.onet.pl
authors: A
authors: A
authors: Lisowska
authors: M
authors: M
authors: Knapp
authors: M
authors: M
authors: Usowicz-Szaryńska
authors: A
authors: A
authors: Kozieradzka
authors: W J
authors: WJ
authors: Musial
authors: S
authors: S
authors: Dobrzycki
mesh_terms: D000368:Aged; D017541:Aneurysm, False / Q000175:diagnosis* / Q000473:pathology; D017130:Angioplasty / Q000379:methods; D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D001164:Arteriovenous Fistula / Q000473:pathology; D017023:Coronary Angiography / Q000379:methods; D005260:Female; D005263:Femoral Artery / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012307:Risk Factors; D016896:Treatment Outcome; D014463:Ultrasonography / Q000379:methods