Kronzon I
Department of Medicine, New York University School of Medicine, New York, USA.
J Am Soc Echocardiogr. 1997 Apr;10(3):236-45. doi: 10.1016/s0894-7317(97)70061-0.
A pseudoaneurysm is a pulsatile hematoma that communicates with an artery through a disruption in the arterial wall. Femoral pseudoaneurysm is a common complication of invasive procedures. It occurs in 0.1% to 0.2% of diagnostic angiograms and 3.5% to 5.5% of interventional procedures. Longer procedures, large-bore catheters, anticoagulation, and a faulty lower site of puncture are associated with a higher incidence of femoral pseudoaneurysm. Pseudoaneurysms are associated with the characteristic findings of a pulsatile mass, a palpable thrill, and an audible to-and-fro murmur. The diagnosis is confirmed by imaging of the pseudoaneurysm. A femoral arterial duplex study is the diagnostic imaging modality of choice. It can show the pseudoaneurysm, the degree of clotting, the communication with the femoral artery, and the blood flow velocity pattern within the artery, the communication, and the pseudoaneurysm. Small (less than 2 cm) femoral pseudoaneurysms clot spontaneously and usually require no treatment. Larger femoral pseudoaneurysms may lead to complications including rupture and compression of the adjacent femoral vein (with resulting venous thrombosis) or of the femoral nerve. Treatment may be surgical. However, recently it has been shown that direct, noninvasive compression of the pseudoaneurysm stops the blood flow in the communication and leads to pseudoaneurysm clotting and obliteration.
假性动脉瘤是一种搏动性血肿，通过动脉壁的破损与动脉相通。股动脉假性动脉瘤是侵入性操作的常见并发症。它在0.1%至0.2%的诊断性血管造影中出现，在3.5%至5.5%的介入性操作中出现。操作时间较长、使用大口径导管、抗凝以及穿刺部位较低有误等情况与股动脉假性动脉瘤的较高发生率相关。假性动脉瘤伴有搏动性肿块、可触及的震颤以及可闻及的来回杂音等特征性表现。通过假性动脉瘤的影像学检查来确诊。股动脉双功超声检查是首选的诊断性影像学方法。它可以显示假性动脉瘤、凝血程度、与股动脉的连通情况以及动脉内的血流速度模式、连通情况和假性动脉瘤。较小（小于2厘米）的股动脉假性动脉瘤可自行凝血，通常无需治疗。较大的股动脉假性动脉瘤可能导致包括破裂以及压迫相邻股静脉（导致静脉血栓形成）或股神经等并发症。治疗方法可能是手术治疗。然而，最近有研究表明，对假性动脉瘤进行直接、非侵入性压迫可阻止连通处的血流，导致假性动脉瘤凝血并闭塞。
