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Influence of anatomical factors on the efficacy of treating femoral pseudoaneurysms with ultrasound-guided compression technique: A prospective cohort study

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Abstract

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.

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References

  1. Kontopodis N, Tsetis D, Tavlas E et al (2016) Ultrasound guided compression versus ultrasound guided thrombin injection for the treatment of post catheterization femoral pseudoaneurysms: systematic review and meta-analysis of comparative studies. Eur J Vasc Endovasc Surg 51:815–823

    Article  CAS  PubMed  Google Scholar 

  2. Katzenschlager R, Ugurluoglu A, Ahmadi A et al (1995) Incidence of pseudoaneurysm after diagnostic and therapeutic angiography. Radiology 195:463–466

    Article  CAS  PubMed  Google Scholar 

  3. Hessel SJ, Adams DF, Abrams HL (1981) Complications of angiography. Radiology 138:273–281

    Article  CAS  PubMed  Google Scholar 

  4. Schneider C, Malisius R, Küchler R et al (2009) A prospective study on ultrasound-guided percutaneous thrombin injection for treatment of iatrogenic postcatheterization femoral pseudoaneurysms. Int J Cardiol 131(3):356–61

  5. ElMahdy MF, Kassem HH, Ewis EB et al (2014) Comparison between ultrasound-guided compression and para-aneurysmal saline injection in the treatment of postcatheterization femoral artery pseudoaneurysms. Am J Cardiol 113:871–876

    Article  PubMed  Google Scholar 

  6. Toursarkissian B, Allen BT, Petrinec D et al (1997) Spontaneous closure of selected iatrogenic pseudoaneurysms and arteriovenous fistulae. J Vasc Surg 25:803–808

    Article  CAS  PubMed  Google Scholar 

  7. Li Y, Chen SH, Spiotta AM et al (2021) Lower complication rates associated with transradial versus transfemoral flow diverting stent placement. J Neurointerv Surg 13:91–95

    Article  PubMed  Google Scholar 

  8. Papadakis M, Zirngibl H, Floros N et al (2016) Iatrogenic femoral pseudoaneurysm and secondary ipsilateral deep vein thrombosis: an indication for early surgical exploration. Ann Vasc Surg 34(269):e13–e15

    Google Scholar 

  9. Yang EY, Tabbara MM, Sanchez PG et al (2018) Comparison of ultrasound-guided thrombin injection of iatrogenic pseudoaneurysms based on neck dimension. Ann Vasc Surg 47:121–127

    Article  PubMed  Google Scholar 

  10. Ahmad F, Turner S, Torrie P et al (2008) Iatrogenic femoral artery pseudoaneurysms—a review of current methods of diagnosis and treatment. Clin Radiol 63(12):1310–1316

    Article  CAS  PubMed  Google Scholar 

  11. Coley BD, Roberts AC, Fellmeth BD et al (1995) Postangiographic femoral artery pseudoaneurysms: further experience with US-guided compression repair. Radiology 194:307–311

    Article  CAS  PubMed  Google Scholar 

  12. Eisenberg L, Paulson EK, Kliewer MA et al (1999) Sonographically guided compression repair of pseudoaneurysms: further experience from a single institution. Am J Roentgenol 173:1567–1573

    Article  CAS  Google Scholar 

  13. Brummer U, Salcuni M, Salvati F et al (2001) Repair of femoral postcatheterization pseudoaneurysm and arteriovenous fistula with percutaneous implantation of endovascular stent. Nephrol Dial Transpl 16:1728–1729

    Article  CAS  Google Scholar 

  14. Edgerton JR, Moore DO, Nichols D et al (2002) Obliteration of femoral artery pseudoaneurysm by thrombin injection. Ann Thorac Surg 74:1413–1415

    Article  Google Scholar 

  15. Huang TL, Liang HL, Huang JS et al (2012) Ultrasound-guided compression repair of peripheral artery pseudoaneurysm: 8 years’ experience of a single institute. J Chin Med Assoc 75(9):468–473

    Article  PubMed  Google Scholar 

  16. de Oliveira Leite TF, Bortolini E et al (2019) Evaluation of morphological and clinical factors related to failure of percutaneous treatment with thrombin injection of femoral pseudoaneurysms from cardiac catheterization. Ann Vasc Surg 59:173–183

    Article  PubMed  Google Scholar 

  17. Şaylik F, Sevi̇mli̇ S (2022) Kardiyak Kataterizasyon Sonrası Gelişen Femoral Psödoanevrizmaların Ultrasonografik Kompresyon Yöntemiyle Kapatma İşlemi Sonrasındaki Kısa ve Orta Dönem Sonuçları. Acta Medica Nicomedia 5(3):157–164

  18. Heis HA, Bani-Hani KE, Elheis MA et al (2008) Postcatheterization femoral artery pseudoaneurysms: therapeutic options. A case-controlled study Int J Surg 6:214–219

    PubMed  Google Scholar 

  19. Kang SS, Labropoulos N, Mansour MA et al (1998) Percutaneous ultrasound guided thrombin injection: a new method for treating postcatheterization femoral pseudoaneurysms. J Vasc Surg 27:1032–1038

    Article  CAS  PubMed  Google Scholar 

  20. Franklin JA, Brigham D, Bogey WM et al (2003) Treatment of iatrogenic false aneurysms. J Am Coll Surg 197:293–301

    Article  PubMed  Google Scholar 

  21. Piedad BT, Kronzon I (2003) Iatrogenic femoral artery pseudoaneurysm. Curr Treat Options Cardiovasc Med 5:103–108

    Article  PubMed  Google Scholar 

  22. Lonn L, Olmarker A, Geterud K et al (2004) Prospective randomized study comparing ultrasound-guided thrombin injection to compression in the treatment of femoral pseudoaneurysms. J Endovasc Ther 11:570–576

    Article  PubMed  Google Scholar 

  23. Lönn L, Olmarker A, Geterud K et al (2002) Treatment of femoral pseudoaneurysms. Percutaneous US-guided thrombin injection versus US-guided compression. Acta Radiol 43:396–400

  24. Popovic B, Freysz L, Chometon F et al (2010) Femoral pseudoaneurysms and current cardiac catheterization: evaluation of risk factors and treatment. Int J Cardiol 14(141):75–80

    Article  Google Scholar 

  25. Shindo S, Kato K, Motohashi S et al (2007) Delayed femoral pseudoaneurysm formation after percutaneous coronary intervention. Clin Imaging 31:162–164

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Radiology, Atasehir Florance Nightingale Hospital, Küçükbakkalköy, Işıklar Cd. No: 35/A, 34750, Ataşehir/Istanbul, Turkey

    Nuri Havan

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  1. Nuri Havan
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Correspondence to Nuri Havan.

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Havan, N. Influence of anatomical factors on the efficacy of treating femoral pseudoaneurysms with ultrasound-guided compression technique: A prospective cohort study. Ir J Med Sci (2023). https://doi.org/10.1007/s11845-023-03581-6

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