Paulson E K, Kliewer M A, Hertzberg B S, Tcheng J E, McCann R L, Bowie J D, Carroll B A
Department of Radiology, Duke University Medical Center, Durham, North Carolina 27710, USA.
J Ultrasound Med. 1995 Sep;14(9):653-9. doi: 10.7863/jum.1995.14.9.653.
To determine the success and complication rates of ultrasonographically guided manual compression in patients with femoral arterial injuries after femoral arterial catheterization, we performed 53 sonographically guided compression repairs in 51 patients. Ultrasonographically guided compression repair was performed on 40 pseudoaneurysms in non-anticoagulated patients, seven pseudoaneurysms in anticoagulated patients, four arteriovenous fistulas on non-anticoagulated patients, and one pseudoaneurysm combined with an arteriovenous fistula. One pseudoaneurysm underwent two separate ultrasonographically guided compression repairs: once when the patient was anticoagulated and once after anticoagulants were withheld. Ultrasonographically guided compression repair was successful in 37 of 48 pseudoaneurysms (77%). Of the 40 pseudoaneurysms in non-anticoagulated patients, ultrasonographically guided compression repair was successful in 36 (90%). This repair technique failed in all seven pseudoaneurysms in anticoagulated patients. Ultrasonographically guided compression repair was successful in 13 of 16 (81%) multilobulated pseudoaneurysms but failed in all arteriovenous fistulas and the one case of pseudoaneurysm combined with an arteriovenous fistula. Ultrasonographically guided compression repair is a safe and effective alternative to surgery for the repair of pseudoaneurysms, including multilobulated pseudoaneurysms. The procedure does not appear to be effective in the anticoagulated patient or in patients with an arteriovenous fistula.
为了确定超声引导下手法压迫治疗股动脉插管后股动脉损伤患者的成功率和并发症发生率，我们对51例患者进行了53次超声引导下压迫修复术。对40例未抗凝患者的假性动脉瘤、7例抗凝患者的假性动脉瘤、4例未抗凝患者的动静脉瘘以及1例合并动静脉瘘的假性动脉瘤进行了超声引导下压迫修复术。1例假性动脉瘤接受了两次单独的超声引导下压迫修复术：一次是在患者抗凝时，一次是在停用抗凝剂后。48例假性动脉瘤中有37例（77%）超声引导下压迫修复术成功。在40例未抗凝患者的假性动脉瘤中，超声引导下压迫修复术成功36例（90%）。这种修复技术在所有7例抗凝患者的假性动脉瘤中均失败。16例多叶状假性动脉瘤中有13例（81%）超声引导下压迫修复术成功，但所有动静脉瘘以及1例合并动静脉瘘的假性动脉瘤均失败。超声引导下压迫修复术是修复假性动脉瘤（包括多叶状假性动脉瘤）的一种安全有效的手术替代方法。该方法在抗凝患者或动静脉瘘患者中似乎无效。
