Pseudoaneurysm and invasive cardiology



Year of publication 2004
Type Article in Periodical
Magazine / Source Scripta medica
MU Faculty or unit

Faculty of Medicine

Keywords pseudoaneurysm; invasive; cardiology; vascular; surgery; complication
Description Invasive cardiology represents an effective method for both diagnosing and treatment of patients with heart diseases. As an invasive procedure it is however accompanied by various complications. Pseudoaneurysm represents a potentially serious peripheral vascular complication of these procedures. The objective of this study was to evaluate the number of pseudoaneurysms solved as a complication of femoral artery punction for diagnostic coronarography and PTCA. One center retrospective study was carried out. The number of coronarographies and PTCA with stenting during the years 1999 and 2003 was evaluated. The amount of pseudoaneurysms treated by vascular surgeons during the same 5-year period was assessed. An analysis of the group of patients operated on post-punction pseudoaneurysm during the period between January 2003 and April 2004 was then attached. 15.419 catheterisations were performed during the past 5 years – namely 11.044 coronarographies (i.e. 71,62 %) and 4.375 PTCAs with stenting (28,38 %). During the same period 75 pseudoaneurysms were surgically treated. So the risk of development of a pseudoaneurysm after invasive cardiology procedures reached 0,49 %. During the 16-month period 18 patients with femoral artery pseudoaneurysm were treated. There were 9 men and 9 women with the average age of 67,4 and 75,1 years, respectively. Acute myocardial ischaemia was solved in 13 patients (72,2%). 15 patients (83,3%) underwent PTCA with or without stenting. Combined antiaggregative and anticoagulant therapy was then given to 12 patients (66,6%), the rest receiving combined antiaggregation. Of the patients 16 (i.e. 88,8%) were operated within 1 to 2 weeks after catheterization. In 11 cases (61,1%) common or superficial femoral artery suture was performed. Deep femoral artery was repaired in 5 (i.e. 27,7%), the rest (11,2%) representing common femoral artery branching injury. The results received are fully comparable to those referred by other invasive cardiology and vascular surgery centres. Operation represents the most useful method of pseudoaneurysm treatment. However, prevention – sufficient postpunction site compression, reasonably high anticoagulation fitting the patient after the cardiac catheterization etc. – still remains the main chance for decreasing number of peripheral vascular complications in invasive cardiology.

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