Methods and option for the management of iatrogenic femoral artery pseudoaneurysms

Abstract

Objective To evaluate the effect on ultrasound-guided locsl comprression and surgical to treat iatrogenic fem- oral artery pseudoanerurysms. Methods 197 patients were diagnosed as iatrogenic femoral artery pseudoaneurysms from Apri 1199 to April 2008.There were 122 male and 75 female, aged 59.7 years (rimed 40- 81 years). One. Hundrel and severty-one stahle cases were managed by ultrasound-guided local compression initially and 26 patients were directly treated with surgical repair because d the rupture of femoral artery pesudoaneurysms or the pseudoaneurysms≥40mm in diameter. Results 171 patients received llocal com- pression therapy, 137 cases were cured directly (the effective rate was 80%), but the last failed 34 cases were required conversion to surgical reparr. The nymber of the surgical repaired patients was 60 (incluing 26 cases with direct operation and 34 cases with required conversion to surgical repair). Forty-seven patients received direct excision of femoral artery pseudoaneurysm, six patients underwent angioplasty with autogenously saphenous vein patch, and seven patients got bypass operation with artificial vascular graft. During the perioperative period, no serious complications including bleeding, neuralgia, and lymphatic fistula even arterio venous fis- tula and so on, no death occurred. All patients were followed up for 1 month to5 years after the procedures, no local FAP recurred, no limb ischemia developed and no deaths occurred. Conclusion Uitrasound-guided compression, surgical repair, and ultrasound- guided percutaneous thrombin injection are the three main modalities of treating iatrogenic FAP, while ultrasound-guided compresson and magical therapy get popularized domestically. Ultrasound-guided comperession seems a safe, inexpensive, and effective method for the managerment of iatrogenic femoral artery pseudoaneurysms. It may be used as a lust-line therapetic modality for mint of the un-complicated patients. However, surgical repair can be reserved for those who failed comperssion therapy or unsuitable as mentioned above. Key words: Aneurysm, false Femoral artry Iatrogenic disease Vascular surgical procedyres