Color duplex-guided compression therapy for postcatheterization pseudoaneurysms in a community hospital

Area of Science:

• Vascular Surgery
• Interventional Radiology
• Medical Devices

Background:

• Postcatheterization pseudoaneurysms are a known complication of arterial procedures.
• Surgical treatment has been the traditional approach for pseudoaneurysms.
• Duplex-guided compression therapy (DGCT) has shown promise in university settings.

Purpose of the Study:

• To evaluate the efficacy and applicability of DGCT in a community hospital setting.
• To compare DGCT outcomes with historical surgical treatment data.
• To identify factors influencing DGCT success or failure.

Main Methods:

• Retrospective review of 63 symptomatic pseudoaneurysms in 62 patients from 1990-1993.
• DGCT was implemented as primary treatment after October 1991, with surgery reserved for failures.
• Patient characteristics, pseudoaneurysm size, and procedure type were analyzed.

Main Results:

• DGCT achieved an initial success rate of 75% (27/36 patients), with a cumulative success of 67% (24/36) after recurrences.
• Failure was more likely in pseudoaneurysms associated with intra-aortic balloon pumps (IABP) and potentially larger pseudoaneurysms.
• Patient intolerance accounted for 3 of 12 DGCT failures; anticoagulation and other factors did not predict outcomes.

Conclusions:

• DGCT is a generally successful and appropriate primary treatment for symptomatic postcatheterization pseudoaneurysms in stable patients.
• The technique is applicable and effective in a community hospital setting.
• Surgery remains an option for DGCT failures or unstable patients.