Treatment of Postinterventional Pseudoaneurysms by Ultrasound-Guided Compression

Steinkamp HJ, Werk M, Felix R. Treatment of postinterventional pseudoaneurysms by ultrasound-guided compression. Invest Radiol 2000;35:186–192. RATIONALE AND OBJECTIVES.This 3-year study was performed to evaluate the effectiveness and safety of ultrasound-guided compression (UGC) in the treatment of postinterventional pseudoaneurysms (PAs). METHODS.One hundred ten PAs were sonographically diagnosed after peripheral or cardiac interventions. In 98 patients (65 men and 33 women; age range, 44–79 years), UGC was performed. The PAs were related to the common femoral artery (n = 78), the superficial femoral artery (n = 26), the profound femoral artery (n = 2), and the distal external iliac artery (n = 4). The PAs showed diameters ranging from 0.8 to 9.86 cm (mean, 4.8 cm) and volumes between 0.6 and 109 mL (mean, 15.6 mL). Follow-up examinations including color Doppler–coded ultrasound and peripheral Doppler were performed after 18 hours ± 6 and 28 days ± 4. RESULTS.Complete closure of the PA and its neck was achieved by UGC in 96 of 98 cases (98%). In 86 of 98 cases (87.8%), UGC was successful during the first session; a second treatment was needed in 10 cases. The compression time varied from 12 to 85 minutes (mean, 35.6 minutes). Except for medically controllable vagal reactions in 4 of 98 cases (4.1%) and 1 easily controlled PA rupture, no treatment-related complications were observed. CONCLUSIONS.According to the effectiveness and safety results, we conclude that UCG is the method of choice in the treatment of postinterventional PAs. Diagnosis and UGC treatment should be performed as early as possible to minimize symptoms and hospitalization time.