PRACTICE OBSERVED Pseudoaneurysm of femoral artery after catheterisation: treatment by a mechanical compression device guided by colour Doppler ultrasound

Background—Femoral artery pseudoaneurysm is a significant complication in patients undergoing diagnostic or therapeutic catheterisation. First choice treatment for pseudoaneurysm is freehand ultrasound guided compression repair, which is time consuming and uncomfortable for the patient and operator. Aim—To explore a mechanical compression device (FemoStop) as an alternative treatment for iatrogenic femoral artery pseudoaneurysm. Methods—Fourteen patients with pseudoaneurysm were considered for treatment with FemoStop after a brief freehand ultrasound guided compression repair to confirm the compressibility of the lesion. The FemoStop compression was applied for 20 minutes. The result was controlled with colour Doppler ultrasound, and a second cycle of 20 minutes followed if necessary. Results—FemoStop compression was successful in 13 of the 14 patients. The mean compression time was 33 minutes (range, 20–60). The mean number of compression periods was 1.6 (range 1–3). FemoStop compression was successful in all 11 patients not taking anticoagulants and in two of three patients receiving anticoagulants. The mean compression time in patients given oral or intravenous anticoagulants was longer (50 v 27 minutes). Colour Doppler ultrasound 12 hours after the procedure indicated no recurrence of pseudoaneurysm in the 13 patients with initial success. Conclusions—FemoStop compression for iatrogenic pseudoaneurysm is feasible, and as safe and eVective as freehand ultrasound guided compression repair. It is more comfortable for the patient and operator, and probably more economical than freehand compression. (Heart 1998;79:502–504)