Duplex-guided compression of iatrogenic femoral pseudoaneurysms.

Abstract

Iatrogenic pseudoaneurysms are a major complication following percutaneous cannulations of the femoral artery. Surgical repair has been the traditional treatment modality. Recent reports have introduced duplex-guided compression as a means of nonoperative management of these injuries. We proposed to determine if duplex-guided compression of femoral pseudoaneurysms could be successfully performed, could be done without complication, and could maintain thrombosis on long-term follow-up. All patients presenting with large groin hematomas following invasive percutaneous femoral artery procedures over a seven-month period were studied using color-flow duplex analysis. Six pseudoaneurysms were discovered and successfully treated with duplex-guided compression. All patients were then followed-up prospectively with both early and long-term repeat duplex analysis. All patients were rescanned 72 hours later and the pseudoaneurysms remained thrombosed. Upon returning for long-term follow-up examination, patients again had duplex confirmation of thrombosis, with a mean follow-up time of 21 months (range, five to 29 months). No complications attributable to this technique have been noted. This study confirms the clinical usefulness of duplex-guided compression in the evaluation and treatment of iatrogenic femoral pseudoaneurysms.