Luedde Mark, Krumsdorf Ulrike, Zehelein Joerg, Ivandic Boris, Dengler Thomas, Katus Hugo A, Tiefenbacher Christiane
Department of Cardiology, University of Heidelberg, Germany.
Angiology. 2007 Aug-Sep;58(4):435-9. doi: 10.1177/0003319706294608.
Development of an arterial pseudoaneurysm is a common complication following cardiac catheterization. We analyzed data from 6,300 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.
动脉假性动脉瘤的形成是心脏导管插入术后常见的并发症。我们分析了在我院接受左心导管插入术的6300例患者的数据。术后一天，约10%的患者接受了双功超声检查。在204例患者（3.0%）中，诊断出股动脉假性动脉瘤。所有患者均接受了压迫治疗。由此，159例假性动脉瘤得以成功治疗。其余45例假性动脉瘤的最大直径超过1.5 cm。42例患者在超声和活检线引导下注射凝血酶，未出现并发症。该策略在41例中成功实现了闭塞。小于2 cm的假性动脉瘤可采用压迫治疗。较大的假性动脉瘤可在超声引导下通过注射凝血酶闭塞。具有宽“颈部”的假性动脉瘤患者应接受手术治疗，因为不能排除注射凝血酶后发生动脉闭塞的风险。
