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Femoral artery pseudoaneurysms: risk factors, prevalence, and treatment options
Colin G Knight1, Dean A Healy, Ronald L Thomas
1Department of Surgery, Allegheny General Hospital, Pittsburgh, PA, USA. knight_colin@yahoo.com
Insights
Femoral artery pseudoaneurysms (PSA) affect 0.28% of patients after procedures. Female sex, interventions, and lack of closure devices are key risk factors for PSA development.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Cardiology
Background:
- Femoral artery pseudoaneurysms (PSA) are a complication of procedures involving femoral artery cannulation.
- PSAs can prolong hospitalization, increase healthcare costs, and lead to significant patient morbidity.
Purpose of the Study:
- To determine the prevalence of femoral artery pseudoaneurysms (PSA).
- To identify independent risk factors associated with PSA development.
- To evaluate treatment options and outcomes for PSA.
Main Methods:
- Retrospective, case-controlled study.
- Analysis of 48 patients diagnosed with PSA at a tertiary-care teaching hospital.
- Logistic regression used to identify risk factors.
Main Results:
- Estimated PSA prevalence was 0.28%, with equal rates in interventional radiology and cardiac catheterization.
- Independent risk factors for PSA included female sex (OR 2.62), undergoing an intervention (OR 3.22), and not using a closure device (OR 10.2).
- Patients with PSA experienced longer hospital stays; no significant difference in complication rates among treatments. Spontaneous resolution was not size-dependent.
Conclusions:
- Female sex, interventional procedures, and absence of closure devices are significant risk factors for femoral artery pseudoaneurysms.
- Thrombin injection and observation represent effective, low-complication treatment strategies for PSA.
- PSA management should consider identified risk factors and effective, minimally invasive treatment options.
Abstract:
Femoral artery pseudoaneurysms (PSA or false aneurysm) develop in about 1% of patients undergoing procedures that require femoral artery cannulation. PSA prolong hospitalization, consuming health-care resources, and result in significant morbidity. We designed a study to review the prevalence, risk factors, and treatment of PSA. We performed a retrospective, case-controlled study of patients diagnosed with PSA at a large, urban, tertiary-care teaching hospital. We reviewed 48 patients with PSA for our study. The estimated prevalence of PSA was 0.28%, with identical rates found for procedures done in the interventional radiology department and in the cardiac catheterization suite. Logistic regression identified three independent risk factors for developing PSA: being female (odds ratio 2.62), having an intervention performed (odds ratio 3.22), and not having a closure device used (odds ratio 10.2). Patients with PSA had longer hospital length of stay than that of patients without PSA. We found no statistically significant difference in failure or complication rates for the four treatment options and that spontaneous resolution of PSA does not correlate with its size. Thrombin injection and observation are effective, low-complication treatment options.
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