Mooney M J, Tollefson D F, Andersen C A, Kanar E A, Weiland C L
Department of Surgery, Blanchfield Army Community Hospital, Fort Campbell, KY, USA.
J Am Coll Surg. 1995 Aug;181(2):155-9.
Iatrogenic pseudoaneurysms are a major complication following percutaneous cannulations of the femoral artery. Surgical repair has been the traditional treatment modality. Recent reports have introduced duplex-guided compression as a means of nonoperative management of these injuries. We proposed to determine if duplex-guided compression of femoral pseudoaneurysms could be successfully performed, could be done without complication, and could maintain thrombosis on long-term follow-up.
All patients presenting with large groin hematomas following invasive percutaneous femoral artery procedures over a seven-month period were studied using color-flow duplex analysis. Six pseudoaneurysms were discovered and successfully treated with duplex-guided compression. All patients were then followed-up prospectively with both early and long-term repeat duplex analysis.
All patients were rescanned 72 hours later and the pseudoaneurysms remained thrombosed. Upon returning for long-term follow-up examination, patients again had duplex confirmation of thrombosis, with a mean follow-up time of 21 months (range, five to 29 months). No complications attributable to this technique have been noted.
This study confirms the clinical usefulness of duplex-guided compression in the evaluation and treatment of iatrogenic femoral pseudoaneurysms.
医源性假性动脉瘤是经皮股动脉插管后的主要并发症。手术修复一直是传统的治疗方式。最近的报告引入了双功超声引导下压迫作为这些损伤的非手术治疗方法。我们旨在确定双功超声引导下压迫股部假性动脉瘤是否能成功实施、是否能无并发症地完成以及在长期随访中能否维持血栓形成。
对在七个月期间因侵入性经皮股动脉操作后出现腹股沟大血肿的所有患者进行彩色血流双功超声分析。发现六例假性动脉瘤并通过双功超声引导下压迫成功治疗。然后对所有患者进行前瞻性随访，包括早期和长期重复双功超声分析。
所有患者在72小时后再次扫描，假性动脉瘤仍保持血栓形成。在进行长期随访检查时，患者再次通过双功超声确认血栓形成，平均随访时间为21个月（范围为5至29个月）。未发现归因于该技术的并发症。
本研究证实了双功超声引导下压迫在医源性股部假性动脉瘤评估和治疗中的临床实用性。
