Abstract
Due to the increased number of arterial punctures performed during angiography and
angioplasty, the incidence of false aneurysms after arterial puncture has increased
in significance. It was reported as 0.05–2%; with careful sonographic follow-up it
may be twice as high. The goal of the retrospective investigation (28 patients with
false aneurysms) was to elucidate risk factors leading to failure of spontaneous closure
of the arterial site, and to examine symptoms and clinical courses. False aneurysms
became manifest on average 16.4 days after puncture. Highest risk was seen in obese
patients (64.3%), where the number of tangential and multiple vessel punctures was
also highest. Further risk factors were local sclerosis, hypertension, diabetes, poor
general condition, and coagulopathies. Twelve false aneurysms (42.8%) were found incidentally;
diagnosis was made in all patients sonographically. In 89.3%, primary suture or patchplasty
was possible and in 10.7%, more extensive vessel replacement was necessary. Postoperative
complications included local infection (7.14%), recurrent false aneurysm (3.5%), and
arterial bleeding (3.5%). At an average follow-up of 4.25 years, no local occlusions
nor recurrent false aneurysms were seen. Preventative measures in high-risk patients
(more precise puncture, prolonged compression) could reduce the morbidity of false
aneurysms after puncture. Longer follow-up period would be necessary to show up the
true incidence of false aneurysms and provide information on the asymptomatic courses.
Surgery must be performed by experienced vascular surgeons as only at time of operation
can the full extent of the arterial lesion be identified and the necessary corrective
vascular procedures be performed.
