DETERMINANTS OF SUCCESS OF COLOR-FLOW DUPLEX-GUIDED COMPRESSION REPAIR OF FEMORAL PSEUDOANEURYSMS

Background. Ultrasonography-guided compression repair is reported to b e effective therapy for femoral pseudoaneurysms that develop after cat heterization procedures. This study summarizes our experience with col or-flow duplex-guided repair of these lesions. Methods. A retrospectiv e chart review of all patients who underwent this procedure was undert aken, with statistical analysis to identify factors associated with su ccess. Results. Compression repair of 69 pseudoaneurysms was attempted . Pseudoaneurysms developed after therapeutic catheterization in 48 pa tients and after diagnostic procedures in 21. Sites of arterial punctu re were the common femoral artery in 59 patients and the superficial f emoral or profunda femoris arteries in 10. Diameters of the pseudoaneu rysms ranged from 3 to 60 mm (mean, 28 mm). Compression was attempted at a mean of 5 days (range, 1 to 21 days) after catheterization. Compr ession produced complete thrombosis of the pseudoaneurysm at the initi al attempt in 43 (62%) of 69 patients. With repeated attempts the ulti mate success was 47 (68%) of 69. Success was achieved in 44 (75%) of 5 9 common femoral pseudoaneurysms but in only 3 (30%) of 10 superficial femoral or profunda femoris lesions (p = 0.009). Anticoagulation, she ath size, pseudoaneurysm chamber size, and time between catheterizatio n and compression were not significantly different between lesions tha t were successfully compressed and those that were not. No ischemic or embolic complications were observed. Conclusions. Color-flow duplex-g uided compression repair can be safely attempted as the initial therap y for all uncomplicated pseudoaneurysms arising from the common femora l artery after catheterization, with the expectation of success in mos t.