[Color Doppler controlled compression therapy of puncture aneurysms--a noninvasive therapy concept]

After transfemoral catheterization, pseudoaneurysms can occur in about 0.1-0.05% of cases, especially after the use of large instruments and a faulty puncture technique. Today, pseudoaneurysms can be easily and accurately diagnosed with the help of duplex and color Doppler ultrasound. Apart from its diagnostic application, color Doppler ultrasound also offers a noninvasive and cheap alternative therapy mode as compared to surgical repair. The purpose of our study was to evaluate the therapeutic efficiency of an ultrasound-guided compression technique for postpunctional pseudoaneurysms. Over a 12-month period, nine patients were sonographically diagnosed with postpunctional pseudoaneurysm of the femoral superficial artery. The compression therapy was only applied if no contraindications (e.g. rupture, retroperitoneal site of the lesion, infection, large haematoma with suspected ischaemia, and necrosis) were present. Two of the nine patients were primarily excluded from therapy because of a high risk of rupture or a large haematoma. Five patients of the remaining seven have been successfully treated. In one of the unsuccessfully treated patients, only a partial thrombosis of the aneurysm was obtained, followed by complete spontaneous thrombosis 4 days later. The second compression failed because of the 4-month time interval between angiography and compression therapy. A successful therapy clearly depended on the time interval between puncture and compression. We could not find any significant correlation between the aneurysm volume and the duration of compression. Color Doppler ultrasound-guided therapy is a noninvasive easily applicable, and cheap alternative to surgical repair of postpunctional pseudoaneurysms.