PSEUDOANEURYSM AFTER CARDIAC-CATHETERIZATION - THERAPEUTIC INTERVENTIONS AND THEIR SEQUELAE - EXPERIENCE IN 86 PATIENTS

After diagnostic cardiac catheterization in 8,715 patients, a pseudoan eurysm was diagnosed in 86 (1%) patients, Primary conservative managem ent by repeated compression bandages (CB) or ultrasound guided compres sion (UGC) was attempted in all patients. Occlusion of the pseudoaneur ysm was achieved significantly more often by Dec (41/47; 87%) than by CB (22/39; 56%; P = 0.016). Of 86 patients, 23 (27%) required surgical treatment. Major clinical acute complications occurred after surgery in 8/23 cases (35%) versus 4/63 (6%; P = 0.0004) following successful CB or UGC. However, intention-to-treat analysis showed no difference i n the rate of acute complications in the CB or UGC group (15.4% versus 12.8%, P = 0.7272), because of a trend towards a higher complication rate following secondary surgery in the UGC (4/6 = 66.7%), as compared to the CB group (4/17 = 23.5%, P = 0.1589), During follow up, 22/64 ( 34%) patients reported persistent inguinal complaints, 9/15 (60%) afte r surgery and 13/49 (27%) after successful CB or UGC (P = 0.0169), How ever, according to the intention-to-treat analysis, there was no signi ficant difference between the initial groups (CB: 26.1% versus UGC: 39 .0%, P = 0.2958). Despite a higher effectiveness of UGC to achieve occ lusion of a pseudoaneurysm compared to CB (87% vs. 56%), UGC is not su perior to CB because of a higher rate of acute complications as well a s long-term complaints in those patients requiring secondary surgery i n the UCG group as compared to the CB group. (C) 1997 Wiley-Liss, Inc.