Service d'Angiologie, Hôpital Cantonal de Fribourg, Fribourg, Switzerland.
EuroIntervention. 2012 Feb;7(10):1206-9. doi: 10.4244/EIJV7I10A192.
Pseudo-aneurysm (PA) of the femoral artery is the most frequent complication after diagnostic or therapeutic catheterisation. PA may manifest with large and painful haematoma or compression of the adjacent nerve and vein. Among several therapeutic approaches, compression by injection of saline around the neck is a recent and promising method. To explore compression with saline as an alternative treatment for iatrogenic femoral artery PA was the aim of this study.
From December 2009 to January 2011, all consecutive patients with symptomatic PA were included in this study. After ultrasonic assessment, the PA neck was occluded by injection of a saline/lidocaïne (0.2%) mixture in the soft tissue at its vicinity, followed by a short echo-guided compression. Outcome was assessed at one and 30 days by duplex sonography. Eleven patients with PA requiring immediate treatment were included. All patients had at least one PA cavity. Moreover, four patients had multiple pulsatile cavities and seven patients had large thigh or abdominal haematoma, with either active bleeding, compression of adjacent organ or hypotension. Three patients had very short PA neck. The mean injected volume was 47±11 ml. The mean compression time until the PA was closed was 6±3 minutes. At one and 30 days, all PA remained occluded without any complication related to the procedure.
Saline injection to seal PA is feasible, safe and very effective. The technique is rapid and well tolerated, and allows, after limited training, the closure of very large PA, even in case of emergency. This new technique is more comfortable for the patient and the operator, and surely more economical than thrombin injection or surgical arterial suture.
股动脉假性动脉瘤（PA）是诊断或治疗性导管插入后的最常见并发症。PA 可能表现为大而疼痛的血肿或邻近神经和静脉受压。在几种治疗方法中，通过在颈部周围注射盐水进行压迫是一种最近的有前途的方法。本研究旨在探索盐水压迫作为医源性股动脉 PA 的替代治疗方法。
从 2009 年 12 月至 2011 年 1 月，所有有症状的 PA 连续患者均纳入本研究。超声评估后，将 PA 颈部通过在其附近的软组织中注射盐水/利多卡因（0.2%）混合物来闭塞，然后进行短暂的超声引导压迫。通过双功超声在 1 天和 30 天评估结果。11 例需要立即治疗的 PA 患者被纳入。所有患者至少有一个 PA 腔。此外，4 例患者有多个搏动性腔，7 例患者大腿或腹部有大血肿，存在活动性出血、邻近器官受压或低血压。3 例患者 PA 颈部非常短。平均注射量为 47±11ml。PA 闭合的平均压迫时间为 6±3 分钟。在 1 天和 30 天，所有 PA 均保持闭塞，无任何与该程序相关的并发症。
用盐水注射封闭 PA 是可行的、安全的且非常有效的。该技术快速且耐受性良好，并且在经过有限的培训后，即使在紧急情况下，也可以闭合非常大的 PA。这种新技术对患者和操作者来说更舒适，并且肯定比凝血酶注射或动脉缝合更经济。
