Ultrasound-guided compression repair for treatment of femoral artery pseudoaneurysm: Acute and follow-up results

Femoral artery pseudoaneurysm is a significant problem in patients undergoing arterial diagnostic or therapeutic catheterization, The aim of this investigation was to report the incidence of pseudoaneurysm after arterial catheterization and the success rate of ultrasound-guided compression repair. During a 3-year period (11/91-11/94) 9,051 patients underwent 7,312 cardiac catheterizations and 1,739 peripheral percutaneous transluminal coronary angioplasty procedures. Patients suspect of pseudoaneurysm were referred for a color Doppler ultrasound examination. All patients with pseudoaneurysm were considered for ultrasound-guided compression repair. Pseudoaneurysm occurred more frequently after interventional procedures with new devices (valvuloplasty 2.3%, stent 3.2%) than after conventional catheterization (diagnostic cardiac catheterization 0.2%, electrophysiology 1.3%, percutaneous transluminal coronary angioplasty 0.2%), The incidence of pseudoaneurysm after peripheral percutaneous coronary transluminal angioplasty, including intra-arterial lysis and stent, was 1%. Ultrasound guided compression repair was successfully performed in 37 of 41 cases with pseudoaneurysm (90%). Ultrasound-guided compression repair was successfully performed in 30 of 31 patients (97%) without anticoagulation and in 7 of 10 patients (70%) receiving anticoagulants (P < 0.05). There was no correlation between mean diameter of the pseudoaneurysm, age of the lesion, or antiplatelet therapy. Color Doppler ultrasound re-examination at up to 3 months indicated successful treatment in all patients. The use of complex interventional catheterization procedures leads to an increased frequency of pseudoaneurysms compared with conventional angiography and percutaneous transluminal coronary angioplasty. Ultrasound-guided compression repair is a noninvasive, efficient, safe and cost-effective therapy for post-catheterization pseudoaneurysm. (C) 1996 Wiley-Liss, Inc.