REGULAR CONTENT
Final ID
586
Type
Educational Exhibit-Poster Only
Authors
S Mukherjee1, G Hastings1, A Harken1
Institutions
1UCSF-EB, Oakland, CA
Purpose
This educational exhibit aims to familiarize interventional operators with the risk factors, the diagnosis of, and the current and novel management of femoral artery pseudo-aneurysms.
Materials & Methods
The femoral artery is the vessel of choice for most endovascular arterial interventions. A femoral artery pseudoaneurysm (FAP) is a known complication and has been reported to occur in up to 6% after interventional procedures and up to 2% post-diagnostic catheterization(1,2). Independent risk factors associated with FAP are female gender, obesity, hypertension, the use of antiplatelet and/or anticoagulant therapy and faulty puncture techniques and puncture location.
Results
FAPs can occur iatrogenically, after trauma, after catheterization, at the site of native artery and synthetic graft anastomosis and secondary to infection(3). Iatrogenic pseudoaneurysms occur when an arterial puncture does not seal, which allows arterial blood to enter the local surrounding tissues and form a pulsatile hematoma(4). FAPs do not have a fibrous wall and are enclosed by an outer layer of hematoma and the overlying soft tissues. It may present clinically as a pulsatile hematoma, a new thrill or bruit, or marked pain and tenderness. In addition, there may be hemodynamic instability particularly if the FAP is complicated. However, in many cases, FAPs may not be associated with any symptoms whatsoever(4). Femoral pseudoaneurysmal complications include rupture, distal embolization, local pain, neuropathy and local skin ischemia(5). Treatment options include ultrasound guided compression and thrombin injection, stent repair, embolization and surgery(6,7). Risk mitigation and strategies for immediate management of these complications will be discussed.
Conclusions
Given the wide and expanding use of femoral artery access for diagnostic and for interventional procedures, familiarity with this common and potentially life threatening complication is essential.
Final ID
586
Type
Educational Exhibit-Poster Only
Authors
S Mukherjee1, G Hastings1, A Harken1
Institutions
1UCSF-EB, Oakland, CA
Purpose
This educational exhibit aims to familiarize interventional operators with the risk factors, the diagnosis of, and the current and novel management of femoral artery pseudo-aneurysms.
Materials & Methods
The femoral artery is the vessel of choice for most endovascular arterial interventions. A femoral artery pseudoaneurysm (FAP) is a known complication and has been reported to occur in up to 6% after interventional procedures and up to 2% post-diagnostic catheterization(1,2). Independent risk factors associated with FAP are female gender, obesity, hypertension, the use of antiplatelet and/or anticoagulant therapy and faulty puncture techniques and puncture location.
Results
FAPs can occur iatrogenically, after trauma, after catheterization, at the site of native artery and synthetic graft anastomosis and secondary to infection(3). Iatrogenic pseudoaneurysms occur when an arterial puncture does not seal, which allows arterial blood to enter the local surrounding tissues and form a pulsatile hematoma(4). FAPs do not have a fibrous wall and are enclosed by an outer layer of hematoma and the overlying soft tissues. It may present clinically as a pulsatile hematoma, a new thrill or bruit, or marked pain and tenderness. In addition, there may be hemodynamic instability particularly if the FAP is complicated. However, in many cases, FAPs may not be associated with any symptoms whatsoever(4). Femoral pseudoaneurysmal complications include rupture, distal embolization, local pain, neuropathy and local skin ischemia(5). Treatment options include ultrasound guided compression and thrombin injection, stent repair, embolization and surgery(6,7). Risk mitigation and strategies for immediate management of these complications will be discussed.
Conclusions
Given the wide and expanding use of femoral artery access for diagnostic and for interventional procedures, familiarity with this common and potentially life threatening complication is essential.