Therapy protocol of ultrasound-guided compression of iatrogenic arterial pseudoaneurysms

Objectives: Ultrasound-guided compression (US-GC) of iatrogenic femoral arterial pseudoaneurysms (ifa-PA) is an adequate method of therapy. However, US-GC is catalogued as a very time-consuming method. The aim of this prospective study was to evaluate the duration of US-GC for treatment of ifa-PA.

Methods: 74 patients with ifa-PA were treated with US-GC. 6 Patients had 2 ifa-PA and 1 Patient had 3. US-GC was applied for 10 minutes intervals with a maximum of 30-min.-compression per day.

Results: The success rate of US-GC was 91% (68 of 74 patients). The other 6 patients underwent US-guided thrombin injection. The mean time of successful compression was 30 minutes. In 70% of patients the thrombosis of the PA was reached in one session. 16 patients required compression for 2 days and 7 for 3 days. The mean time of US-guided thrombin injection was 20min, when considering all the steps of this method (preparation of the injection, determination of the best US-way for the punction of the PA, correct positioning of the needle, thrombin application and evaluation after the injection).

Conclusions: Succesful US-GC of ifa-PA can be performed in a reasonable time. Performing our therapy protocol (10min. intervals with no more than 30 minutes of compression/day), the duration of US-GC for ifa-PA is not very much longer than other sonographic examinations (such as, for example, color Doppler US of the extracranial arteries).