Background. The paper discusses the issue of iatrogenic femoral artery pseudoaneurysm treatement and initial results of color Doppler ultrasound-guided compression repair of pseudoaneurysms.
Material and methods. In the group of 18,000 patients subjected to femoral endovascular procedures, the Doppler examinations were performed in 194 individuals suspected of persistent arterial damage. The B-mode, Color and Power Doppler images were assessed. On examination, the blood flows in the common, superficial and deep femoral arteries above and below the typical site of puncture were measured. In the patients with the diagnosis of pseudoaneurysms, the color Doppler ultrasound-guided compression tests were performed. When the compression test was effective, compression was continued for 30-60 minutes until the image without the signal of blood flow in the pseudoaneurysm was obtained. When the compression test was ineffective or the control Doppler examination revealed the blood flow within the pseudoaneurysm, the patients were sent for surgical treatment.
Results. Pseudoaneurysms were found in 42 patients, i.e. 0.23% of all the patients subjected to artery catheterization procedures and 21.6% of those suspected of persistent femoral artery damage. No artery damage was detected in 144 patients, in 7 cases the arteriovenous fistulas were diagnosed. In one patient, the examination revealed concurrent pseudoaneurysm and arteriovenous fistula. None of the patients showed the disorders of the femoral artery patency. The ultrasound-guided compression tests were performed in 39 patients. Compression repair was successful in 17 patients (40.5%) with diagnosed pseudoaneurysms. The remaining patients with pseudoaneurysms and arteriovenous fistulas were treated surgically.
Conclusions. Color Doppler ultrasound-guided compression repair of iatrogenic femoral artery pseudoaneurysms is a safe method and should be used as an initial stage of treatment. Proper qualifications and experience are required to obtain good results. Successful compression repair is beneficial to patients, shortens the hospital stay and reduces the cost of treatment.