DUPLEX-GUIDED COMPRESSION OF IATROGENIC FEMORAL PSEUDOANEURYSMS

BACKGROUND: Iatrogenic pseudoaneurysms are a major complication follow ing percutaneous cannulations of the femoral artery. Surgical repair h as been the traditional treatment modality, Recent reports have introd uced duplex-guided compression as a means of nonoperative management o f these injuries. We proposed to determine if duplex-guided compressio n of femoral pseudoaneurysms could be successfully performed, could be done without complication, and could maintain thrombosis on long-term follow-up. STUDY DESIGN All patients presenting with large groin hema tomas 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. Ah patients were then followed-up prospectively wi th both early and long-term repeat duplex analysis. RESULTS: All patie nts were rescanned 72 hours later and the pseudoaneurysms remained thr ombosed. Upon returning for long-term follow-up examination, patients again had duplex confirmation of thrombosis, with a mean follow-up tim e of 21 months (range, five to 29 months). No complications attributab le to this technique have been noted. CONCLUSIONS: This study confirms the clinical usefulness of duplex-guided compression in the evaluatio n and treatment of iatrogenic femoral pseudoaneurysms.