Differential diagnosis and repair of femoral artery pseudoaneurysms: report of clinical experience using color Doppler imaging.

Sixty-two sonograms of the groin in 58 patients referred after cardiac catheterization (n = 45) or local surgical by-pass (n = 13) were reviewed retrospectively to determine the accuracy of color Doppler imaging in distinguishing femoral artery pseudoaneurysms from other causes of groin masses (e.g. hematomas) and to evaluate the therapeutical impact of US-guided compression. Thirty-seven cases of pseudoaneurysm, three arteriovenous fistulae (one isolated and two associated with a pseudoaneurysm), sixteen hematomas and eight other conditions were studied; US-guided compression repair was considered to treat thirteen pseudoaneurysms. The sensitivity and specificity of color Doppler imaging by comparison with angiography and/or surgery in the detection of femoral artery pseudoaneurysm was 100% and 94% respectively. US-guided compression repair was not attempted in 2/13 cases (one critical leg ischemia and one unsuitable anatomy) and successful in 7/11 cases. We conclude that color Doppler imaging is of great value in the differential diagnosis of groin masses, reducing the number of diagnostic and pretherapeutic angiographies. However, in our experience, US-guided compression repair is effective in the treatment of no more than 54% (7/13 cases) of nonselected femoral pseudoaneurysms.