Treatment of post cardiac catherization femoral artery false aneurysms using ultrasound guided compression therapy, experience at King Hussein medical center

Abstract EN

Objectives: To evaluate the ultrasound guided compression therapy as a modality of treating femoral false aneurysm in patients post cardiac catheterization and identify factors that affect its technical success.

Methods: This is a retrospective study conducted at the vascular surgery department at King Hussein Medical Center in Amman -Jordan during the period of December 2012 and March 2015.

Eighty five patients were enrolled in the study, being referred from cardiology clinic at Queen Alia Heart Institute in Amman with femoral false aneurysms post cardiac catheterization.

Using duplex ultrasound system transducer arrays, Ultrasound guided compression therapy in our vascular surgery laboratory was used to treat these patients femoral false aneurysms.

We have collected and analyzed the specific data regarding false aneurysms anatomic and morphologic characteristics and patients related factors, and evaluate their effect on the success of treatment.

Results: Over 28 month time period, 85 patients with femoral false aneurysms were treated using ultrasound guided compression therapy.

Successful compression of the false aneurysm and complete thrombosis of the sac was achieved in 65 patients (76.47%).

While in 20 patients (34.48 %) ,the procedure was unsuccessful after three attempted trials.

Failed compression was reported in 6 patients ( 7 % ) in the first session of compression, who succeeded compression in the second session trial of compression therapy.

Among the patient group who failed compression after three trials, 65 % of patients had false aneurysm originated from superficial femoral artery and 3 % had false aneurysm raised from the profunda femoris artery, While 91 % of the patients who succeeded compression had false aneurysm raised from the main common femoral artery.

The size of the false aneurysm also affected ultrasound compression sequel, with 40 % of the failed group had size of false aneurysm more than 3.5cm.

We had experience one patient with complicated rupture of false aneurysm during the procedure and no patient who succeeded compression had recurrence in the follow up period.

Conclusion: Among the therapeutic modalities of treating femoral false aneurysm post cardiac catheterization, ultrasound guided compression therapy is considered an effective and safe modality; it has a high success rate with few complications.

Several factors decreased the efficacy of the procedure including large size of the false aneurysm and site of origin being not in the common femoral artery.