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Treatment of Iatrogenic Femoral Pseudoaneurysm by Ultrasound-Guided Compression Therapy and Thrombin Injection

Department of Cardiology, University of Heidelberg, Germany, mark.luedde{at}med.uni-heidelberg.de

Ulrike Krumsdorf, MD

Department of Cardiology, University of Heidelberg, Germany

Joerg Zehelein, MD

Department of Cardiology, University of Heidelberg, Germany

Boris Ivandic, MD

Department of Cardiology, University of Heidelberg, Germany

Thomas Dengler, MD

Department of Cardiology, University of Heidelberg, Germany

Hugo A. Katus, MD

Department of Cardiology, University of Heidelberg, Germany

Christiane Tiefenbacher, MD

Department of Cardiology, University of Heidelberg, Germany

Development of an arterial pseudoaneurysm is a common complication following cardiac catheterization. We analyzed data from 6300 patients who received left heart catheterization at our institution. One day after the procedure, approximately 10% of the patients were examined with duplex sonography. In 204 patients (3.0%), a pseudoaneurysm of the femoral artery was diagnosed. All patients underwent compression therapy. Thereby, 159 of the pseudoaneurysms could be treated successfully. The remaining 45 pseudoaneurysms had a maximal diameter of more than 1.5 cm. Forty-two patients underwent ultrasound and biopsy-line—guided thrombin injection without complications. This strategy resulted in a successful occlusion in 41 cases. Pseudoaneurysms smaller than 2 cm can be treated with compression therapy. Larger pseudoaneurysms can be occluded by thrombin injection using ultrasound guidance. Patients with a pseudoaneurysm with a wide "neck" should be treated surgically, because the risk of an arterial occlusion following thrombin injection cannot be excluded.

Angiology, Vol. 58, No. 4, 435-439 (2007)
DOI: 10.1177/0003319706294608


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