Access site pseudoaneurysms after endovascular intervention for peripheral arterial diseases

Ahmed Eleshra, Daehwan Kim, Hyung Sub Park, Taeseung Lee

Research output: Contribution to journalReview articleResearchpeer-review

Abstract

Purpose: Pseudoaneurysms after percutaneous vascular access are common and potentially fatal if left untreated. The aim of this study was to determine the incidence and risk factors associated with access site pseudoaneurysms after endovascular intervention for peripheral arterial disease (PAD) under a routine postintervention ultrasound (US) surveillance protocol. Methods: A total of 254 PAD interventions were performed in a single center between January 2015 and November 2016, and puncture site duplex US surveillance was routinely performed within 48 hours of the procedure. Clinical, procedural and follow-up US data were analyzed. Results: The overall incidence of pseudoaneurysm was 2.75% (6 cases in the femoral artery and 1 in the brachial artery). There was no difference between retrograde and antegrade approach, but there was a higher rate of pseudoaneurysm formation after manual compression compared to arterial closure device (ACD) use (4.3% vs. 0.87%). Manual compression was more commonly used for antegrade punctures (79.0%) and ACD for retrograde punctures (67.7%). Calcification was more frequently found in antegrade approach cases (46.8% vs. 16.9% for retrograde cases) and manual compression was preferred in its presence. All pseudoaneurysms were treated successfully at the time of diagnosis by US-guided compression repair and there were no cases of rupture. Conclusion: Pseudoaneurysm rates after therapeutic endovascular intervention for PAD were comparable to other cardiologic or interventional radiologic procedures despite the higher possibility of having a diseased access vessel. Routine US surveillance of access sites allowed for early diagnosis and noninvasive treatment of pseudoaneurysms, preventing potentially fatal complications.

Original languageEnglish
Pages (from-to)305-312
Number of pages8
JournalAnnals of Surgical Treatment and Research
Volume96
Issue number6
DOIs
StatePublished - 1 Jun 2019

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Peripheral Arterial Disease
False Aneurysm
Punctures
Equipment and Supplies
Brachial Artery
Incidence
Femoral Artery
Blood Vessels
Early Diagnosis
Rupture
Therapeutics

Keywords

  • Complications
  • Endovascular procedures
  • False aneurysm
  • Peripheral arterial disease
  • Vascular closure devices

Cite this

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title = "Access site pseudoaneurysms after endovascular intervention for peripheral arterial diseases",
abstract = "Purpose: Pseudoaneurysms after percutaneous vascular access are common and potentially fatal if left untreated. The aim of this study was to determine the incidence and risk factors associated with access site pseudoaneurysms after endovascular intervention for peripheral arterial disease (PAD) under a routine postintervention ultrasound (US) surveillance protocol. Methods: A total of 254 PAD interventions were performed in a single center between January 2015 and November 2016, and puncture site duplex US surveillance was routinely performed within 48 hours of the procedure. Clinical, procedural and follow-up US data were analyzed. Results: The overall incidence of pseudoaneurysm was 2.75{\%} (6 cases in the femoral artery and 1 in the brachial artery). There was no difference between retrograde and antegrade approach, but there was a higher rate of pseudoaneurysm formation after manual compression compared to arterial closure device (ACD) use (4.3{\%} vs. 0.87{\%}). Manual compression was more commonly used for antegrade punctures (79.0{\%}) and ACD for retrograde punctures (67.7{\%}). Calcification was more frequently found in antegrade approach cases (46.8{\%} vs. 16.9{\%} for retrograde cases) and manual compression was preferred in its presence. All pseudoaneurysms were treated successfully at the time of diagnosis by US-guided compression repair and there were no cases of rupture. Conclusion: Pseudoaneurysm rates after therapeutic endovascular intervention for PAD were comparable to other cardiologic or interventional radiologic procedures despite the higher possibility of having a diseased access vessel. Routine US surveillance of access sites allowed for early diagnosis and noninvasive treatment of pseudoaneurysms, preventing potentially fatal complications.",
keywords = "Complications, Endovascular procedures, False aneurysm, Peripheral arterial disease, Vascular closure devices",
author = "Ahmed Eleshra and Daehwan Kim and Park, {Hyung Sub} and Taeseung Lee",
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Access site pseudoaneurysms after endovascular intervention for peripheral arterial diseases. / Eleshra, Ahmed; Kim, Daehwan; Park, Hyung Sub; Lee, Taeseung.

In: Annals of Surgical Treatment and Research, Vol. 96, No. 6, 01.06.2019, p. 305-312.

Research output: Contribution to journalReview articleResearchpeer-review

TY - JOUR

T1 - Access site pseudoaneurysms after endovascular intervention for peripheral arterial diseases

AU - Eleshra, Ahmed

AU - Kim, Daehwan

AU - Park, Hyung Sub

AU - Lee, Taeseung

PY - 2019/6/1

Y1 - 2019/6/1

N2 - Purpose: Pseudoaneurysms after percutaneous vascular access are common and potentially fatal if left untreated. The aim of this study was to determine the incidence and risk factors associated with access site pseudoaneurysms after endovascular intervention for peripheral arterial disease (PAD) under a routine postintervention ultrasound (US) surveillance protocol. Methods: A total of 254 PAD interventions were performed in a single center between January 2015 and November 2016, and puncture site duplex US surveillance was routinely performed within 48 hours of the procedure. Clinical, procedural and follow-up US data were analyzed. Results: The overall incidence of pseudoaneurysm was 2.75% (6 cases in the femoral artery and 1 in the brachial artery). There was no difference between retrograde and antegrade approach, but there was a higher rate of pseudoaneurysm formation after manual compression compared to arterial closure device (ACD) use (4.3% vs. 0.87%). Manual compression was more commonly used for antegrade punctures (79.0%) and ACD for retrograde punctures (67.7%). Calcification was more frequently found in antegrade approach cases (46.8% vs. 16.9% for retrograde cases) and manual compression was preferred in its presence. All pseudoaneurysms were treated successfully at the time of diagnosis by US-guided compression repair and there were no cases of rupture. Conclusion: Pseudoaneurysm rates after therapeutic endovascular intervention for PAD were comparable to other cardiologic or interventional radiologic procedures despite the higher possibility of having a diseased access vessel. Routine US surveillance of access sites allowed for early diagnosis and noninvasive treatment of pseudoaneurysms, preventing potentially fatal complications.

AB - Purpose: Pseudoaneurysms after percutaneous vascular access are common and potentially fatal if left untreated. The aim of this study was to determine the incidence and risk factors associated with access site pseudoaneurysms after endovascular intervention for peripheral arterial disease (PAD) under a routine postintervention ultrasound (US) surveillance protocol. Methods: A total of 254 PAD interventions were performed in a single center between January 2015 and November 2016, and puncture site duplex US surveillance was routinely performed within 48 hours of the procedure. Clinical, procedural and follow-up US data were analyzed. Results: The overall incidence of pseudoaneurysm was 2.75% (6 cases in the femoral artery and 1 in the brachial artery). There was no difference between retrograde and antegrade approach, but there was a higher rate of pseudoaneurysm formation after manual compression compared to arterial closure device (ACD) use (4.3% vs. 0.87%). Manual compression was more commonly used for antegrade punctures (79.0%) and ACD for retrograde punctures (67.7%). Calcification was more frequently found in antegrade approach cases (46.8% vs. 16.9% for retrograde cases) and manual compression was preferred in its presence. All pseudoaneurysms were treated successfully at the time of diagnosis by US-guided compression repair and there were no cases of rupture. Conclusion: Pseudoaneurysm rates after therapeutic endovascular intervention for PAD were comparable to other cardiologic or interventional radiologic procedures despite the higher possibility of having a diseased access vessel. Routine US surveillance of access sites allowed for early diagnosis and noninvasive treatment of pseudoaneurysms, preventing potentially fatal complications.

KW - Complications

KW - Endovascular procedures

KW - False aneurysm

KW - Peripheral arterial disease

KW - Vascular closure devices

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U2 - 10.4174/astr.2019.96.6.305

DO - 10.4174/astr.2019.96.6.305

M3 - Review article

VL - 96

SP - 305

EP - 312

JO - Annals of Surgical Treatment and Research

JF - Annals of Surgical Treatment and Research

SN - 2288-6575

IS - 6

ER -