Background

Femoral pseudoaneursysm treatment is still controversial.

Aims

The aim of this study was to evaluate the anatomic features related to femoral pseudoaneurysm (FPA) closure failure for ultrasound-guided compression (USGC).

Methods

This was a single-center, prospective, cohort study. FPA patients admitted to the radiology department for USGC were included in the study. Age, sex, duration of FPA, thrombosis, ratio of thrombosis to FPA diameter, feeding artery, tortiosity, connection properties, length and width of the neck, volume, and fistula-to-common femoral artery (CFA) speed ratio were reported during color Doppler ultrasonography (CDUS) scanning.

Results

The study was completed with 192 patients. FPA compression therapy was successful in 155 patients and failed in 37 patients. FPA without a narrow connection (p < 0.001), FPA without existing thrombosis (p < 0.001), a lower thrombosis ratio (p < 0.001), a longer duration of FPA (p = 0.035), a shorter neck length, a wider neck width (p < 0.001), and a higher fistula-to-CFA speed rate (p < 0.001) were related to FPA closure failure with USGC. ROC analysis of the fistula-to-CFA speed ratio showed that a ratio of 1.01 had 47% sensitivity and 63% specificity for USGC treatment failure (AUC, 0.72; p < 0.05).

Conclusions

Failure of FPA closure with USGC is closely related to anatomic features of FPA. Evaluating the anatomical features of FPA before deciding the treatment method can be beneficial for patients and clinicians.

中文翻译：

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解剖因素对超声引导加压技术治疗股骨假性动脉瘤疗效的影响：一项前瞻性队列研究

背景

股骨假性动脉瘤的治疗仍存在争议。

目标

本研究的目的是评估与超声引导加压 (USGC) 股骨假性动脉瘤 (FPA) 闭合失败相关的解剖学特征。

方法

这是一项单中心、前瞻性队列研究。该研究纳入了 USGC 放射科收治的 FPA 患者。年龄、性别、FPA 持续时间、血栓形成、血栓形成与 FPA 直径的比率、供血动脉、扭曲度、连接特性、颈部长度和宽度、体积以及瘘管与股总动脉 (CFA) 速度比彩色多普勒超声（CDUS）扫描。

结果

该研究共有 192 名患者参与。FPA 加压疗法对 155 名患者成功，对 37 名患者失败。无狭窄连接的 FPA ( p  < 0.001)、无血栓的 FPA ( p <  0.001)、较低的血栓形成率 ( p  < 0.001)、较长的 FPA 持续时间 ( p  = 0.035)、较短的颈部长度、较宽的颈部宽度 ( p  < 0.001) 和较高的瘘管至 CFA 速度 ( p  < 0.001) 与 USGC 的 FPA 闭合失败相关。瘘管与 CFA 速度比的 ROC 分析显示，比率为 1.01 对 USGC 治疗失败的敏感性为 47%，特异性为 63%（AUC，0.72；p  < 0.05）。

结论

USGC FPA 闭合失败与 FPA 的解剖特征密切相关。在决定治疗方法之前评估 FPA 的解剖特征对于患者和临床医生来说都是有益的。