Ultrasound Guided Compression Versus Ultrasound Guided Thrombin Injection for the Treatment of Post-Catheterization Femoral Pseudoaneurysms: Systematic Review and Meta-Analysis of Comparative Studies

Kontopodis, Nikolaos; Tsetis, Dimitrios; Tavlas, Emmanouil; Dedes, Athansios; Ioannou, Christos V.

doi:10.1016/j.ejvs.2016.02.012

Cited by 39 publications

(33 citation statements)

References 35 publications

(27 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Comparisons of means of continuous variables between procedural successes versus pseudoaneurysm recurrences were performed by the unpaired Student t test or the Mann‐Whitney test, as appropriate. Comparisons of categorical variables between these groups were performed by the χ test or the Fisher exact test, as appropriate. Multivariate logistic regression analysis with the binary outcome of procedural success versus postprocedural pseudoaneurysm recurrence was performed.…”

Section: Methodsmentioning

confidence: 99%

“…Although pseudoaneurysms are contained structures, they are at risk for acute rupture and are associated with hemodynamic compromise. Additionally, they can cause pain, swelling, overlying skin ischemia, and compression of nearby structures . Therefore, pseudoaneurysms require close follow‐up to ensure thrombosis and avoid complications.…”

mentioning

confidence: 99%

“…Ultrasound‐guided injection of recombinant thrombin into the pseudoaneurysm sac to achieve pseudoaneurysm thrombosis is an off‐label procedure that has become standard treatment for extremity pseudoaneurysms. A 2016 systematic review and meta‐analysis by Kontopodis et al concluded that ultrasound‐guided thrombin injection is significantly more efficacious than ultrasound‐guided compression, and both are equally safe.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Recurrence of Thrombin‐Injected Pseudoaneurysms Under Ultrasound Guidance: A 10‐Year Retrospective Analysis

Esterson

Pellerito

2017

J of Ultrasound Medicine

View full text Add to dashboard Cite

show abstract

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Recurrence of Thrombin‐Injected Pseudoaneurysms Under Ultrasound Guidance: A 10‐Year Retrospective Analysis

Esterson

Pellerito

2017

J of Ultrasound Medicine

View full text Add to dashboard Cite

show abstract

“…1,3–5 FPA can cause local symptoms and signs, often hemodynamic instability and possible mortality. 6 The clinical presentation can be acute persistent pain at the puncture site, an expanding hematoma, a pulsating mass, feeling a thrill, decrease in hemoglobin level, hypotension, distal ischemia, tachycardia, chronic persistent pain due to compression neuropathy, clinical evidence of local site infection and it can be an incidental finding. 2,3,6–10 Important information can be obtained by color Doppler ultrasound such as the site of arterial defect, size of the aneurysm, neck diameter, connecting tract length, aneurysmal flow and the dimensions of surrounding hematoma.…”

Section: Introductionmentioning

confidence: 99%

Risk factors attributed to failure of ultrasound-guided compression for post-cardiac catheterization femoral artery pseudoaneurysms

et al. 2019

View full text Add to dashboard Cite

Background: Femoral pseudoaneurysm is the most important access site complication following cardiac catheterization. Ultrasound-guided compression repair is a safe and effective therapeutic modality with variable failure rates and risk factors. The aim of this study was to investigate which factors were associated with a higher incidence of ultrasound-guided compression repair failure for post-cardiac catheterization femoral pseudoaneurysm. Methods: Data were retrospectively collected from medical records at King Abdullah University Hospital during the period from January 2011 to December 2016. A total of 42 patients with post-cardiac catheterization femoral pseudoaneurysm had attempted ultrasound-guided compression repair. Data regarding patients, procedure and aneurysm-related factors were evaluated by univariate analysis and multivariate logistic regression. Results: Ultrasound-guided compression repair failed in 31% of the patients. Patients with body mass index of ⩾28 kg/m 2 , platelet count of ⩽180,000/L, time lag (age of aneurysm) of >48 h following puncture time, aneurysmal neck diameter of ⩾4 mm and communicating tract length of <8 mm were associated with higher rate of ultrasound-guided compression repair failure in the univariate analysis. In the multivariate analysis, time lag (age of aneurysm) > 48 h (odds ratio = 5.7), body mass index ⩾ 28 kg/m 2 (odds ratio = 7.8), neck diameter > 4 mm (odds ratio = 14.4) and tract length < 8 mm (odds ratio = 18.6) were significantly associated with ultrasound-guided compression repair failure. Conclusion: Ultrasound-guided compression repair for patients with post-cardiac catheterization femoral pseudoaneurysm was successful in 69% of the patients. Risk factors for failed ultrasound-guided compression repair were as follows: delayed ultrasound-guided compression repair of >48 h, body mass index ⩾ 28 kg/m 2 , wide neck diameter > 4 mm and short aneurysmal communication tract < 8 mm.

show abstract

“…Finally, iatrogenic dissections may heal spontaneously or require endovascular treatment via contralateral or brachial access. Whereas self-expanding stents are used in the external iliac arteries, CFA dissection requires balloon angioplasty, since stents placed there are at high risk of fracture [ 5 , 16 , 20 , 25 , 26 ].…”

Section: Complications Of Femoral Arterial Accessmentioning

confidence: 99%

Multidetector CT of iatrogenic and self-inflicted vascular lesions and infections at the groin

Tonolini

Ierardi

Carrafiello³

et al. 2018

Insights Imaging

View full text Add to dashboard Cite

The number and complexity of endovascular procedures performed via either arterial or venous access are steadily increasing. Albeit associated with higher morbidity compared to the radial approach, the traditional common femoral artery remains the preferred access site in a variety of cardiac, aortic, oncologic and peripheral vascular procedures. Both transarterial and venous cannulation (for electrophysiology, intravenous laser ablation and central catheterisation) at the groin may result in potentially severe vascular access site complications (VASC). Furthermore, vascular and soft-tissue groin infections may develop after untreated VASC or secondarily to non-sterile injections for recreational drug use. VASC and groin infections require rapid diagnosis and appropriate treatment to avoid further, potentially devastating harm. Whereas in the past colour Doppler ultrasound was generally used, in recent years cardiologists, vascular surgeons and interventional radiologists increasingly rely on pelvic and femoral CT angiography. Despite drawbacks of ionising radiation and the need for intravenous contrast, multidetector CT rapidly and consistently provides a panoramic, comprehensive visualisation, which is crucial for correct choice between conservative, endovascular and surgical management. This paper aims to provide radiologists with an increased familiarity with iatrogenic and self-inflicted VASC and infections at the groin by presenting examples of haematomas, active bleeding, pseudoaneurysms, arterial occlusion, arterio-venous fistula, endovenous heat-induced thrombosis, septic thrombophlebitis, soft-tissue infections at the groin, and late sequelae of venous injuries.Teaching Points• Complications may develop after femoral arterial or venous access for interventional procedures.• Arterial injuries include bleeding, pseudoaneurysm, occlusion, arteriovenous fistula, dissection.• Endovenous heat-induced thrombosis is a specific form of iatrogenic venous complication.• Iatrogenic infections include groin cellulitis, abscesses and septic thrombophlebitis.• CT angiography reliably triages vascular access site complications and groin infections.

show abstract

Ultrasound Guided Compression Versus Ultrasound Guided Thrombin Injection for the Treatment of Post-Catheterization Femoral Pseudoaneurysms: Systematic Review and Meta-Analysis of Comparative Studies

Abstract: Available evidence suggests that UGTI is superior in terms of efficacy and as safe as UGC and thus should be used as the primary modality for the treatment of post-catheterization femoral pseudoaneurysms.

Cited by 39 publications

References 35 publications

Recurrence of Thrombin‐Injected Pseudoaneurysms Under Ultrasound Guidance: A 10‐Year Retrospective Analysis

Recurrence of Thrombin‐Injected Pseudoaneurysms Under Ultrasound Guidance: A 10‐Year Retrospective Analysis

Risk factors attributed to failure of ultrasound-guided compression for post-cardiac catheterization femoral artery pseudoaneurysms

Multidetector CT of iatrogenic and self-inflicted vascular lesions and infections at the groin

Contact Info

Product

Resources

About