Sonographically guided compression repair of pseudoaneurysms: further experience from a single institution

OBJECTIVE. Our purpose was to perform a comprehensive review of our experie nce with compression of postcatheterization groin pseudoaneurysms. MATERIALS AND METHODS, Two hundred eighty-one patients underwent 306 sonogr aphically guided compression procedures on 297 groin pseudoaneurysms after femoral artery catheterization. The medical records, cardiac catheterizatio n reports, and sonographic images were reviewed to determine patient demogr aphics, type of catheterization procedure performed, sheath size, access si te, interval from sheath removal to compression, anticoagulation status, ps eudoaneurysm dimensions, complications, and follow-up information. Statisti cal analysis was performed using Pearson's chi-square and Kendall tau tests . RESULTS. The success rate for the initial compression attempt was 72.1%. Of the 83 failed compression attempts, 12 patients underwent a second attempt , of which seven attempts were successful. Therefore, counting both first a nd second attempts, the success rate was 74.4%. A strong negative correlati on existed between anticoagulation status and success, with a 70% failure r ate in patients with anticoagulated blood. Smaller pseudoaneurysm size was strongly correlated with success. Of the 83 failed cases, 49 ultimately und erwent surgical repair. Eleven complications (3.6%) occurred, including thr ee patients with rupture during compression. No deaths occurred as a result of compression repair. CONCLUSION. We conclude that sonographically guided pseudoaneurysm compress ion repair is an effective alternative to surgical repair, though nearly on e third of compression attempts will fail and most of those patients will u ltimately require surgery. The procedure is less effective when the patient 's blood is anticoagulated and when the pseudoaneurysm is large. The proced ure carries an overall complication rate of 3.6% and a risk for rupture of 1%.