Rath J, Marx R, Ganschow U S, Gradaus F, Schoebel F C, Kelm M, Hennersdorf M, Köhler M, Heintzen M P, Strauer B E
Medizinische Klinik und Poliklinik B, Heinrich-Heine-Universität Düsseldorf.
Dtsch Med Wochenschr. 1997 Jun 13;122(24):771-7. doi: 10.1055/s-2008-1047687.
As pseudoaneurysm of the femoral artery after catheter introduction is a frequent complication, its causes and therapeutic options were investigated in a large patient collective.
In a prospective study with colour-Doppler duplex sonography of 6928 patients after diagnostic and of 3764 after interventional cardiac catheterisation, pseudoaneurysms were diagnosed in 80 patients (0.75%), 46 after diagnostic (0.66%) and 34 after interventional (0.9%) catheterisation.
The incidence was higher in women than men (1.33% vs 0.58%; P < 0.05). Anticoagulation after sheath removal was the leading risk factor (n = 55, 68.8%), especially after interventional coronary intervention 85.3 vs 56.5%, P < 0.05). Local compression under duplex sonography monitoring was undertaken in 69 patients (86.3%), achieving aneurysmal obliteration in 53 (76.8%). Spontaneous thrombosis occurred in 15 of the remaining 27 patients, and surgical closure became necessary in 12.
These data indicate a risk profile for the occurrence of pseudoaneurysm after cardiac catheterisation which can be dealt with by preventive measures. Local compression under duplex sonographic monitoring was the treatment of choice with a high success rate and low incidence of complications.
由于导管插入术后股动脉假性动脉瘤是一种常见并发症，因此在一个大型患者群体中对其病因和治疗选择进行了研究。
在一项对6928例诊断性心脏导管插入术后患者和3764例介入性心脏导管插入术后患者进行彩色多普勒超声检查的前瞻性研究中，80例患者（0.75%）被诊断为假性动脉瘤，其中46例为诊断性导管插入术后（0.66%），34例为介入性导管插入术后（0.9%）。
女性的发病率高于男性（1.33%对0.58%；P<0.05）。拔鞘后抗凝是主要危险因素（n=55，68.8%），尤其是在介入性冠状动脉介入术后（85.3%对56.5%，P<0.05）。69例患者（86.3%）在彩色多普勒超声监测下进行了局部压迫，其中53例（76.8%）动脉瘤闭塞。其余27例患者中有15例发生自发性血栓形成，12例需要手术闭合。
这些数据表明心脏导管插入术后假性动脉瘤发生的风险特征，可通过预防措施加以应对。彩色多普勒超声监测下的局部压迫是首选治疗方法，成功率高且并发症发生率低。
