THE DURABILITY OF DUPLEX-DIRECTED MANUAL OCCLUSION OF FEMORAL FALSE ANEURYSMS

Duplex-directed manual occlusion (DDMO) has emerged as a first line tr eatment in selected cases of iatrogenic pseudoaneurysms related to int erventional and therapeutic femoral artery cannulations. Early recurre nces after successful closure of femoral false aneurysms (FFA) are des cribed in the literature; however, very little long-term follow-up dat a are available. Therefore, the authors reviewed their experience with DDMO of 45 FFAs between February 1991 and December 1994. Follow-up wa s arranged to assess the durability of this noninvasive procedure. DDM O was unsuccessful in three of 45 FFAs (6.6%). Symptomatic recurrences of two FFAs were documented by repeat duplex ultrasound at 7 and 20 d ays post DDMO. Repeat DDMO was successful on one whereas the other req uired surgical closure. One additional patient experienced persistent groin discomfort despite successful DDMO necessitating surgical evacua tion of a large hematoma. Four patients died during the follow-up peri od. Thirty-five patients with 36 FFAs remained eligible for long-term evaluation. Three were lost to follow-up and six patients were intervi ewed by phone and denied symptoms suggestive of recurrence but refused further follow-up. Twenty-six patients with a history of 24 FFAs unde rwent repeat duplex scans. No recurrent FFAs were identified with mean follow-up of 17.5 months (range 1-35). The authors conclude that DDMO is a safe, effective, and durable treatment of iatrogenic femoral fal se aneurysms.