Ultrasound-guided compression of iatrogenic femoral pseudoaneurysm failure, recurrence, and long-term results

Hajarizadeh, Homayon; LaRosa, Charles R.; Cardullo, Paul A.; Rohrer, Michael J.; Cutler, Bruce S.

doi:10.1016/s0741-5214(95)70010-2

Cited by 114 publications

(55 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Ultrasound-guided compression has replaced surgical revision owing to its low rate of complications and high rate of success (83-95%) 16 ; however, the success rate is still lower than that of operative intervention. Given the high recurrence rate in anticoagulated patients and the need for sedation and analgesia, ultrasound-guided compression has yielded to ultrasound-guided intra-aneurysmal thrombin injection as a preferred modality in some clinical situations.…”

Section: Discussionmentioning

confidence: 99%

“…Compression is deemed successful when the absence of flow or the presence of a thrombus is confirmed by colour flow imaging. 16 Although painful, time-consuming, and difficult when used on large pseudoaneurysms, the technique has a high success rate. 17 However, there are no reports of the successful employment of ultrasound-guided compression obliteration in children.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Pseudoaneurysm formation following a traumatic wrist laceration

Poonai

Lim

Lynch

2011

CJEM

View full text Add to dashboard Cite

Pseudoaneurysms occur secondary to partial disruption of the arterial wall. They are a commonly described complication of arterial injury, with penetrating injury and iatrogenic arterial catheterization being the most common etiologies in children. Many present weeks to months after the injury, and the initial vascular injury is often missed. The complications of pseudoaneurysm, which include thromboembolism, neurapraxia, and compartment syndrome, underscore the importance of early recognition and management. Definitive therapy consists of ultrasound-guided compression or resection and possible graft interposition. We describe a case of pseudoaneurysm formation in the radial artery of an adolescent girl 6 weeks following a penetrating injury. The patient's injury was complicated by sensory and motor deficits consistent with ulnar nerve compression. This case attests to the importance of adequately ruling out arterial injury in penetrating injury and close followup if the history is suggestive. In addition, a high index of suspicion is warranted to facilitate imaging of a pulsatile mass to avoid confusion of a thrombosed artery with an abscess. RÉ SUMÉLes pseudoané vrismes sont le ré sultat d'une rupture partielle de la paroi arté rielle. C'est une complication couramment dé crite de la lé sion arté rielle, la blessure pé né trante et le cathé té risme arté riel iatrogè ne constituant les é tiologies les plus fré quentes chez les enfants. Ils se pré sentent à l'urgence des semaines, voire des mois aprè s le traumatisme, et la blessure vasculaire initiale n'est souvent pas repé ré e. Les complications du pseudoané vrisme, dont la thromboembolie, la neurapraxie, et le syndrome des loges, soulignent l'importance du dé pistage et de sa prise en charge pré coces. La compression é choguidé e ou la ré section et possiblement l'interposition d'une greffe repré sentent le traitement dé finitif. Nous dé crivons un cas de pseudoané vrisme dans l'artè re radiale d'une adolescente 6 semaines aprè s une blessure pé né trante. La blessure de la patiente a é té aggravé e par des dé ficits sensoriels et moteurs compatibles avec une compression du nerf cubital. Ce cas dé montre l'importance d'exclure la lé sion arté rielle en cas de blessure pé né trante et de faire un suivi é troit en pré sence d'anté cé dents é vocateurs. En outre, un haut degré de suspicion est justifié pour faciliter l'imagerie d'une masse pulsatile afin d'é viter toute confusion entre une artè re thrombosé e et un abcè s.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Pseudoaneurysm formation following a traumatic wrist laceration

Poonai

Lim

Lynch

2011

CJEM

View full text Add to dashboard Cite

show abstract

“…Ultrasound-guided compression therapy is the first-line therapy and has a high success rate of 80% to 95% [12][13][14][15]. In patients with large, painful hematomas or AV fistula, a higher failure rate is expected, especially if they are receiving anticoagulants [16,17].…”

Section: Discussionmentioning

confidence: 99%

“…About 80%-95% of false aneurysms can be treated successfully by ultrasound-guided compression repair (UGCR) [12][13][14][15], but the success rate is significantly lower in patients on treatment with heparin or anticoagulants and in patients with large AV fistulas [16,17]. The successful closure of a large iatrogenic AV fistula by percutaneous implantation of a covered stent in December 1994 [18] prompted us to use interventional techniques prospectively in all patients with iatrogenic false aneurysms or AV fistulas that could not be treated successfully by repeated UGCR.…”

Section: Introductionmentioning

confidence: 99%

Percutaneous treatment of pseudoaneurysms and arteriovenous fistulas after invasive vascular procedures

Waigand

Uhlich

Groß

et al. 1999

Cathet. Cardiovasc. Intervent.

View full text Add to dashboard Cite

“…17,21 The procedure itself carries particular risks of femoral artery thrombosis or distal embolization. 14,17 Factors such as hand fatigue of the operator and patient intolerance of the compression (one patient in our series) may be important, and can cause failure. 14,21 Adequate pressure at the puncture site after angiographic procedures, both in terms of amount and time, is a good prophylaxis against formation of false aneurysms.…”

Section: Discussionmentioning

confidence: 96%

Management Plan of Post-Angiography False Aneurysms of the Groin

Souka

Buckenham

1999

Ann Saudi Med

View full text Add to dashboard Cite

Background: False aneurysm (FA) of the groin is a potentially serious complication of angiographic procedures. We developed a management plan at St. George's Hospital, and prospectively applied it to 14 consecutive cases over a period of one year. Patients and Methods: This report is a prospective cohort study of post-angiography false aneurysms-. Fourteen patients with groin FA presented to the vascular team between October 1995 and September 1996 (0.2% of 6926 angiographic procedures). Nine of the 14 patients were fully anticoagulated at the time of treatment. Ultrasoundguided compression (USGC) was tried in 11 patients and was considered inappropriate in three. Embolization was attempted in four patients and surgery was needed in seven patients. Results: The initial angiographic procedure was therapeutic in nine and diagnostic in five patients. The median maximal dimension of the FA was 3 cm (range 2-5). USGC was successful in three patients and failed in eight, seven of them fully anticoagulated at the time of compression. Embolization of the FA was tried in four patients; all were anticoagulated, and embolization was successful. Surgery was required in seven patients, one with infected groin and bleeding, another with FA at the site of a groin graft anastomosis, three with concomitant evacuation of large groin hematomas, one who refused further angiographic procedures, and one who needed prolonged full anticoagulation before the availability of the embolization. The operation was successful in all the patients except one, who died of myocardial infarction 24 hours after successful surgical closure of a FA. Conclusion: FA can be managed in a step-wise manner, starting with the noninvasive USGC, embolization and surgery. Surgery is indicated if evacuation of a large hematoma is required, or the presence of infection is suspected. Emergency surgery is indicated for bleeding or imminent rupture.

show abstract

Ultrasound-guided compression of iatrogenic femoral pseudoaneurysm failure, recurrence, and long-term results

Cited by 114 publications

References 25 publications

Pseudoaneurysm formation following a traumatic wrist laceration

Pseudoaneurysm formation following a traumatic wrist laceration

Percutaneous treatment of pseudoaneurysms and arteriovenous fistulas after invasive vascular procedures

Management Plan of Post-Angiography False Aneurysms of the Groin

Contact Info

Product

Resources

About