Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC.
J Chin Med Assoc. 2012 Sep;75(9):468-73. doi: 10.1016/j.jcma.2012.06.020. Epub 2012 Aug 11.
Femoral artery pseudoaneurysm is a rare complication but with increasing frequency nowadays due to the advances of endovascular intervention. Rare cases of brachial or popliteal artery pseudoaneurysms had ever been reported and the predictive factors of failed ultrasound-guided compression repair (UGCR) are controversial.
During the past 8 years, 21 patients (12 males and nine females; median age, 64 years) with peripheral pseudoaneurysms (femoral artery, n = 17; brachial artery, n = 3; popliteal artery, n = 1) were enrolled. A high frequency of 10-12 MHz color ultrasound was used to evaluate the presence of a pseudoaneurysm. The area of the pseudoaneurysm sac and the width and length of the pseudoaneurysm neck were recorded. Under real-time ultrasound guiding, gradual pressure was applied with the probe to obliterate flow in the pseudoaneurysm neck while still allowing flow through the supplying artery for approximately 10-15 minutes with at most three times (45 minutes' compression). Follow-up color sonography was obtained at 24 hours to detect any recurrence.
The mean area and the largest dimension of the 21 pseudoaneurysms were 7.3 ± 6.5 cm(2) and 3.6 ± 1.8 cm, respectively. The mean width and the mean length of the pseudoaneurysm neck were 2.1 ± 0.9 and 3.3 ± 2.0 mm, respectively. Successful thrombosis of the pseudoaneurysm was achieved in 19(90.5%) patients. The mean compression time of the 19 successful UGCR was 21.2 ± 11.0 minutes. Two patients failed the UGCR procedure after a 45-minute compression. Both of the two pseudoaneurysms were located in the femoral artery with a large width of the pseudoaneurysm neck (4 and 5 mm, respectively).
UGCR is a safe and cost-effective therapy for treating peripheral pseudoaneurysms of not only femoral artery, but also brachial artery and popliteal artery. We considered the width of the pseudoaneurysm neck to be the predictive factor of technical success.
股动脉假性动脉瘤是一种罕见的并发症，但由于血管内介入治疗的进步，其发生率正逐渐增加。曾有过肱动脉或腘动脉假性动脉瘤的罕见病例报道，而超声引导压迫修复（UGCR）失败的预测因素仍存在争议。
在过去的 8 年中，共纳入 21 例（男 12 例，女 9 例；中位年龄 64 岁）外周假性动脉瘤患者（股动脉 17 例，肱动脉 3 例，腘动脉 1 例）。采用高频 10-12MHz 彩色超声评估假性动脉瘤的存在。记录假性动脉瘤囊的面积以及假性动脉瘤颈部的宽度和长度。在实时超声引导下，用探头逐渐加压，使假性动脉瘤颈部的血流闭塞，同时仍允许供应动脉血流通过，持续约 10-15 分钟，最多进行 3 次（45 分钟压迫）。用彩色超声在 24 小时进行随访，以检测任何复发。
21 个假性动脉瘤的平均面积和最大直径分别为 7.3±6.5cm2和 3.6±1.8cm。假性动脉瘤颈部的平均宽度和平均长度分别为 2.1±0.9mm 和 3.3±2.0mm。19 例（90.5%）患者假性动脉瘤成功血栓形成。19 例成功 UGCR 的平均压迫时间为 21.2±11.0 分钟。2 例患者在 45 分钟压迫后 UGCR 失败。这两个假性动脉瘤均位于股动脉，假性动脉瘤颈部较宽（分别为 4mm 和 5mm）。
UGCR 是一种安全且具有成本效益的治疗方法，不仅可用于治疗股动脉假性动脉瘤，还可用于治疗肱动脉和腘动脉假性动脉瘤。我们认为假性动脉瘤颈部的宽度是技术成功的预测因素。
Zotero 插件