title: Characteristics of Pseudoaneurysms in Northern India; Risk Analysis, Clinical Profile, Surgical Management and Outcome.
abstract: OBJECTIVE
  To determine the risk factors, clinical characteristics, surgical management and outcome of pseudoaneurysm secondary to iatrogenic or traumatic vascular injury.
  
  
  METHODS
  This was a cross-sectional study being performed in department of cardiovascular and thoracic surgery skims soura during a 4-year period. We included all the patients referring to our center with primary diagnosis of pseudoaneurysm. The pseudoaneurysm was diagnosed with angiography and color Doppler sonography. The clinical and demographic characteristics were recorded and the risk factors were identified accordingly. Patients with small swelling (less than 5-cm) and without any complication were managed conservatively. They were followed for progression and development of complications in relation to swelling. Others underwent surgical repair and excision. The outcome of the patients was also recorded.
  
  
  RESULTS
  Overall we included 20 patients with pseudoaneurysm. The mean age of the patients was 42.1±0.6 years. Among them there were 11 (55%) men and 9 (45%) women. Nine (45%) patients with end stage renal disease developed pseudoaneurysm after inadvertent femoral artery puncture for hemodialysis; two patients after interventional cardiology procedure; one after femoral embolectomy; one developed after fire arm splinter injury and one formed femoral artery related pseudoaneurysm after drainage of right inguinal abscess. The most common site of pseudoaneurysm was femoral artery followed by brachial artery. Overall surgical intervention was performed in 17 (85%) patients and 3 (15%) were managed conservatively.
  
  
  CONCLUSIONS
  End stage renal disease is a major risk factor for pseudoaneurysm formation. Coagulopathy, either therapeutic or pathological is also an important risk factor. Patients with these risk factors need cannulation of venous structures for hemodialysis under ultrasound guide to prevent inadvertent arterial injury. Patients with end stage renal disease who sustain inadvertent arterial puncture during cannulation for hemodialysis should receive compression dressings for 5 to 7 days.
authors.affiliation: Department of Cardiovascular and thoracic Surgery, Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Soura Srinagar (Jammu and Kashmir), India.
authors.forename: Hafeezulla
authors.initials: H
authors.lastname: Lone
authors.affiliation: Department of Cardiovascular and thoracic Surgery, Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Soura Srinagar (Jammu and Kashmir), India.
authors.forename: Farooq Ahmad
authors.initials: FA
authors.lastname: Ganaie
authors.affiliation: Department of Cardiovascular and thoracic Surgery, Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Soura Srinagar (Jammu and Kashmir), India.
authors.forename: Ghulam Nabi
authors.initials: GN
authors.lastname: Lone
authors.affiliation: Department of Cardiovascular and thoracic Surgery, Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Soura Srinagar (Jammu and Kashmir), India.
authors.forename: Abdul Majeed
authors.initials: AM
authors.lastname: Dar
authors.affiliation: Department of Cardiovascular and thoracic Surgery, Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Soura Srinagar (Jammu and Kashmir), India.
authors.forename: Mohammad Akbar
authors.initials: MA
authors.lastname: Bhat
authors.affiliation: Department of Cardiovascular and thoracic Surgery, Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Soura Srinagar (Jammu and Kashmir), India.
authors.forename: Shyam
authors.initials: S
authors.lastname: Singh
authors.affiliation: Department of General medicine, Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Soura Srinagar (Jammu and Kashmir), India.
authors.forename: Khursheed Ahmad
authors.initials: KA
authors.lastname: Parra
keywords: ESRD; End stage renal disease; Hemodialysis; Pseudoaneurysm; Risk factors