Pseudoaneurysm after cardiac catheterization: Therapeutic interventions and their sequelae: Experience in 86 patients
✍ Scribed by Zahn, Ralf ;Thoma, Sylvia ;Fromm, Elke ;Lotter, Raimond ;Zander, Matthias ;Seidl, Karlheinz ;Senges, Jochen
- Publisher
- John Wiley and Sons
- Year
- 1997
- Tongue
- English
- Weight
- 173 KB
- Volume
- 40
- Category
- Article
- ISSN
- 0098-6569
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✦ Synopsis
After diagnostic cardiac catheterization in 8,715 patients, a pseudoaneurysm was diagnosed in 86 (1%) patients. Primary conservative management by repeated compression bandages (CB) or ultrasound guided compression (UGC) was attempted in all patients. Occlusion of the pseudoaneurysm was achieved significantly more often by UGC (41/47; 87%) than by CB (22/39; 56%; P 5 0.016). Of 86 patients, 23 (27%) required surgical treatment. Major clinical acute complications occurred after surgery in 8/23 cases (35%) versus 4/63 (6%; P 5 0.0004) following successful CB or UGC. However, intention-totreat analysis showed no difference in the rate of acute complications in the CB or UGC group (15.4% versus 12.8%, P 5 0.7272), because of a trend towards a higher complication rate following secondary surgery in the UGC (4/6 5 66.7%), as compared to the CB group (4/17 5 23.5%, P 5 0.1589). During follow up, 22/64 (34%) patients reported persistent inguinal complaints, 9/15 (60%) after surgery and 13/49 (27%) after successful CB or UGC (P 5 0.0169). However, according to the intention-to-treat analysis, there was no significant difference between the initial groups (CB: 26.1% versus UGC: 39.0%, P 5 0.2958).
Despite a higher effectiveness of UGC to achieve occlusion of a pseudoaneurysm compared to CB (87% vs. 56%), UGC is not superior to CB because of a higher rate of acute complications as well as long-term complaints in those patients requiring secondary surgery in the UCG group as compared to the CB group.