The Importance of Ultrasound-Guided Manual Compression in Iatrogenic Pseudoaneurysm Treatment: The Sooner the Better


Abstract views: 69 / PDF downloads: 71

Authors

DOI:

https://doi.org/10.5152/EurJTher.2022.21114

Keywords:

Compression, pseudoaneurysm, ultrasound

Abstract

Objective: Although ultrasound-guided manual compression is a safe and cost-effective method in the treatment of pseudoaneurysm, there are many factors affecting the success of the procedure. This study aimed to determine the factors affecting the success of ultrasound-guided manual compression.

Methods: The records of patients who developed iatrogenic femoral artery pseudoaneurysm in the cardiology department between 2017 and 2020 were retrospectively analyzed. Data regarding patients, procedural and aneurysm-related factors were evaluated by univariate and multivariate logistic regression analysis.

Results: Seventy-five patients who underwent ultrasound-guided manual compression were included in our study. In study population, the rate of successful ultrasound-guided manual compression is 72%. As a result of the univariate analysis, hypertension, diabetes mellitus, sheath size, the length of aneurysm sac, the width of aneurysm sac, compression duration, aneurysm detection time> 24 hours parameters were found to be significant predictors for failed ultrasound-guided manual compression. In the multivariate analysis, it was found that the independent predictors associated with failed ultrasound-guided manual compression were the aneurysm detection time longer than 24 hours and the length of aneurysm sac (odds ratio: 5.908; 95% CI 1.136-30.720; P=.035 and odds ratio: 1.042; 95% CI 1.008-1.100; P=.045). In receiver operating characteristic (ROC) curve analysis, the length of the pseudoaneurysm sac of 34 mm and above had 90% sensitivity and 57% specificity for failed ultrasoundguided manual compression.

Conclusions: Ultrasound-guided manual compression is an effective method in the treatment of pseudoaneurysm. However, early detection and size of pseudoaneurysm are important for the success of this treatment. Checking the operation site within the first 24 hours after catheterization is important for early diagnosis and treatment of possible complications. In addition, it should be considered that treatment success is low in length of pseudoaneurysm sacs longer than 34 mm.

Metrics

Metrics Loading ...

References

Asrar Ul Haq M, Tsay IM, Dinh DT, et al. Prevalence and outcomes of trans-radial access for percutaneous coronary intervention in contemporary practise. Int J Cardiol. 2016;221:264-268.

Feldman DN, Swaminathan RV, Kaltenbach LA, et al. Adoption of radial access and comparison of outcomes to femoral access in percutaneous coronary intervention: an updated report from the national cardiovascular data registry (2007-2012). Circulation. 2013;127(23):2295-2306.

Lewis DR, Bullbulia RA, Murphy P, et al. Vascular surgical intervention for complications of cardiovascular radiology: 13 years’ experience in a single centre. Ann R Coll Surg Engl. 1999;81(1):23-26. Available at: https ://pu bmed. ncbi. nlm.n ih.go v/103 25680/

Babu SC, Piccorelli GO, Shah PM, Stein JH, Clauss RH. Incidence and results of arterial complications among 16,350 patients undergoing cardiac catheterization. J Vasc Surg. 1989;10(2):113-116.

Lumsden AB, Miller JM, Kosinski AS, et al. A prospective evaluation of surgically treated groin complications following percutaneous cardiac procedures. Am Surg. 1994;60(2):132-137. Available at: https ://pu bmed. ncbi. nlm.n ih.go v/830 4645/

Omoigui NA, Califf RM, Pieper K, et al. Peripheral vascular complications in the Coronary Angioplasty Versus Excisional Atherectomy Trial (CAVEAT-I). J Am Coll Cardiol. 1995;26(4):922-930.

Fellmeth BD, Roberts AC, Bookstein JJ, et al. Postangiographic femoral artery injuries: nonsurgical repair with US-guided compression. Radiology. 1991;178(3):671-675.

Hertz SM, Brener BJ. Ultrasound-guided pseudoaneurysm compression: efficacy after coronary stenting and angioplasty. J Vasc Surg. 1997;26(6):913-916.

Lange P, Houe T, Helgstrand UJ. The efficacy of ultrasound-guided compression of iatrogenic femoral pseudo-aneurysms. Eur J Vasc Endovasc Surg. 2001;21(3):248-250.

Çakır H, Tuncel Ç, Uncu H, Ökten CC, Karaca S, Özsöyler İ. Iatrogenic femoral artery pseudoaneurysms. Türk Göğüs Kalp Damar Cerrahisi Derg. 2013;21(1):54-58.

Hood DB, Mattos MA, Douglas MG, et al. Determinants of success of color-flow duplex-guided compression repair of femoral pseudoaneurysms. Surgery. 1996;120(4):585-588.

Popovic B, Freysz L, Chometon F,et al. Femoral pseudoaneurysm and current cardiac catheterization: evaluation of risk factors and treatment. Int J Cardiol. 2010;141(1):75-80.

Schaub F, Theiss W, Busch R, Heinz M, Paschalidis M, Schömig A. Management of 219 consecutive cases of post catheterization pseudo aneurysm. Jacc. 1997;30(3):670-675.

Kontopodis N, Tsetis D, Tavlas E, Dedes A, Ioannou CV. Ultrasound guided compression versus ultrasound guided thrombin injection for the treatment of post-catheterization femoral pseudoaneurysms: systematic review and meta-analysis of comparative Studies. Eur J Vasc Endovasc Surg. 2016;51(6):815-823.

Eisenberg L, Paulson EK, Kliewer MA, Hudson MP, DeLong DM, Carroll BA. Sonographically guided compression repair of pseudoaneurysms: further experience from a single institution. AJR Am J Roentgenol. 1999;173(6):1567-1573.

Stone PA, Campbell JE, AbuRahma AF. Femoral pseudoaneurysm after percutaneous access. J Vasc Surg. 2014;60(5):1359-1366.

Paschalidis M, Theiss W, Kölling K, Busch R, Schömig A. Randomised comparison of manual compression repair versus ultrasound guided compression repair of postcatheterisation femoral pseudoaneurysms. Heart. 2006;92(2):251-252.

Coley BD, Roberts AC, Fellmeth BD, Valji K, Bookstein JJ, Hye RJ. Postangiographic femoral artery pseudoaneurysms: further experience with US-guided compression repair. Radiology. 1995;194(2):307-311.

Cox GS, Young JR, Gray BR, Grubb MW, Hertzer NR. Ultrasoundguided compression repair of postcatheterization pseudoaneurysms: results of treatment in one hundred cases. J Vasc Surg.1994;19(4):683-686.

Shatnawi NJ, Al-zoubi NA , Jarrah J, Khader Y , Heis M, Mamoon H. Al-Omari Risk factors attributed to failure of ultrasound-guided compression for post-cardiac catheterization femoral artery pseudoaneurysms. SAGE Open Med. 2019;7:1-6.

Dean SM, Olin JW, Piedmonte M, Grubb M, Young JR. Ultrasoundguided compression closure of postcatheterization pseudoaneurysms during concurrent anticoagulation: a review of seventy-seven patients. J Vasc Surg. 1996;23(1):28-35.

Kumins NH, Landau DS, Montalvo J, et al., Expanded indications for the treatment of postcatheterization femoral pseudoaneurysms with ultrasound-guided compression. Am J Surg. 1998;176(2):131-136.

Downloads

Published

2022-09-26

How to Cite

Kuş, G., Bayar, N., Çağırcı, G., Özgünoğlu, E. C., Güven, R., & Arslan, Şakir. (2022). The Importance of Ultrasound-Guided Manual Compression in Iatrogenic Pseudoaneurysm Treatment: The Sooner the Better. European Journal of Therapeutics, 28(3), 236–241. https://doi.org/10.5152/EurJTher.2022.21114

Issue

Section

Original Articles