Pan Fu-shun, Xie Xiao-yan, Lin Ying, Huang Xue-ling, Zheng Yan-ling, Liang Jin-yu, Li Xiao-xi
Department of Ultrasound, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510080, China.
Zhonghua Wai Ke Za Zhi. 2012 Apr;50(4):302-5.
To evaluate relative factors affecting the efficiency of ultrasound-guided compression repair in iatrogenic femoral artery pseudoaneurysm.
Ultrasound-guided manual compression was performed in 42 patients of iatrogenic femoral artery pseudoaneurysm from June 2004 to June 2010. There were 28 male and 14 female patients, with a mean age of (52 ± 5) years. These patients were presented with femoral artery pseudoaneurysm after catheterisation procedure by percutaneous femoral artery puncture and confirmed by color doppler flow image. Ultrasound-guided manual persistent compression with probe was performed at the puncture site between femoral artery and pseudoaneurysm, until completely thrombosis of pseudoaneurysm, whereas the pseudoaneurysm failed to complete closure required surgical repair.
Out of 42 patients, 34 patients (81.0%) were successfully treated by compression resulted in completely thrombosis. There were 8 (19.0%) failures conversion to surgery. Factors associated with success were size of pseudoaneurysm (< 25 mm, 25 - 40 mm, > 40 mm; χ(2) = 13.956, P = 0.001), anti-coagulation status (χ(2) = 5.578, P = 0.010), depth of artery break (< 50 mm, 50 - 80 mm, > 80 mm; χ(2) = 14.055, P = 0.001), pseudoaneurysm communicated with common femoral artery, superficial femoral artery and profunda femoral artery (χ(2) = 8.968, P = 0.011), as well as days to presented with pseudoaneurysm (< 3 d, ≥ 3 d; χ(2) = 5.733, P = 0.012). In multivariate Logistic regression analysis, success by compression was associated with size of pseudoaneurysm (WALD = 5.34, P = 0.021) and with depth of artery break (WALD = 4.84, P = 0.028).
The ultrasound-guided compression repair of iatrogenic femoral artery pseudoaneurysm is safe, convenient, inexpensive and reliable treatment.
评估影响医源性股动脉假性动脉瘤超声引导下压迫修复效果的相关因素。
对2004年6月至2010年6月间42例医源性股动脉假性动脉瘤患者实施超声引导下手法压迫。其中男性28例，女性14例，平均年龄（52±5）岁。这些患者经皮股动脉穿刺导管术后出现股动脉假性动脉瘤，经彩色多普勒血流显像确诊。在股动脉与假性动脉瘤之间的穿刺部位，用探头进行超声引导下手法持续压迫，直至假性动脉瘤完全血栓形成，而假性动脉瘤未能完全闭合者则需手术修复。
42例患者中，34例（81.0%）经压迫成功治疗，导致完全血栓形成。8例（19.0%）失败转而接受手术。与成功相关的因素有假性动脉瘤大小（<25mm、25 - 40mm、>40mm；χ(2)=13.956，P = 0.001）、抗凝状态（χ(2)=5.578，P = 0.010）、动脉破裂深度（<50mm、50 - 80mm、>80mm；χ(2)=14.055，P = 0.001）、假性动脉瘤与股总动脉、股浅动脉和股深动脉相通（χ(2)=8.968，P = 0.011），以及出现假性动脉瘤的天数（<3天、≥3天；χ(2)=5.733，P = 0.012）。多因素Logistic回归分析显示，压迫成功与假性动脉瘤大小（WALD = 5.34，P = 0.021）和动脉破裂深度（WALD = 4.84，P = 0.028）有关。
超声引导下压迫修复医源性股动脉假性动脉瘤是一种安全、便捷、廉价且可靠的治疗方法。
