title: Percutaneous instillation of physiological saline solution for the treatment of femoral pseudoaneuryms.
abstract: OBJECTIVE
  To investigate the efficacy of para-aneurysmal saline injection for closure of postcatheterization pseudo-aneurysm (PA) at the vascular access site.
  
  
  METHODS
  Fifty-one consecutive patients with postcatheterization PA at the vascular access site were included to undergo percutaneous para-aneurysmal saline injection. In case of technical failure the day after, PA were treated by bovine thrombin injection. Anatomical properties of the PA were recorded as were details to injection.
  
  
  RESULTS
  Initially all patients exhibited success which was reduced to 43 % at day one. A saline volume of median 7 ml (interquartile range 6-8 ml) has been injected. The amount of injected saline was not different in patients with and without treatment success at day one (P = 0.6). Several anatomical properties of the PA exhibited marked differences in patients with or without success. The length (10.3 mm (7.8-12.0) vs. 12.5 mm (10.3-15.0); P = 0.009) and the angulation (110° (100-118) vs. 140° (129-146); P < 0.001) of the fistula/vessel axis was statistically different between groups. The peak systolic velocity failed to show significance with a tendency to higher values in the ineffective study group (P = 0.07). No peripheral complications occurred.
  
  
  CONCLUSIONS
  Para-aneurysmal saline injection may be a therapeutic alternative to percutaneous thrombin injection in patients exhibiting favorable anatomical properties.
authors.affiliation: Department of Internal Medicine II, Division of Angiology, Vienna General Hospital-Medical School, Währinger Gürtel 18-20, 1090, Vienna, Austria.
authors.forename: Georgiana-Aura
authors.initials: GA
authors.lastname: Giurgea
authors.affiliation: Department of Vascular Surgery, Wilhelminenspital Vienna, Vienna, Austria.
authors.forename: Irene
authors.initials: I
authors.lastname: Mlekusch
authors.affiliation: Department of Internal Medicine II, Division of Angiology, Vienna General Hospital-Medical School, Währinger Gürtel 18-20, 1090, Vienna, Austria.
authors.forename: Matthias
authors.initials: M
authors.lastname: Hoke
authors.affiliation: Clinical Pharmacology and Pharmacoepidemiology, University Heidelberg, Heidelberg, Germany.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Carls
authors.affiliation: Department of Internal Medicine II, Division of Angiology, Vienna General Hospital-Medical School, Währinger Gürtel 18-20, 1090, Vienna, Austria.
authors.forename: Schila
authors.initials: S
authors.lastname: Sabeti-Sandor
authors.affiliation: Department of Internal Medicine II, Division of Angiology, Vienna General Hospital-Medical School, Währinger Gürtel 18-20, 1090, Vienna, Austria.
authors.forename: Erich
authors.initials: E
authors.lastname: Minar
authors.affiliation: Department of Internal Medicine II, Division of Angiology, Vienna General Hospital-Medical School, Währinger Gürtel 18-20, 1090, Vienna, Austria. wolfgang.mlekusch@meduniwien.ac.at.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Mlekusch
mesh_terms: D000368:Aged; D017541:Aneurysm, False / Q000175:diagnosis* / Q000188:drug therapy* / Q000209:etiology; D002406:Catheterization, Peripheral / Q000009:adverse effects*; D004305:Dose-Response Relationship, Drug; D005240:Feasibility Studies; D005260:Female; D005263:Femoral Artery / Q000187:drug effects*; D006801:Humans; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged; D012965:Sodium Chloride / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D012965:Sodium Chloride
keywords: femoral artery pseudoaneurysm; para-aneurysmal saline injection