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Ultrasound-Guided Compression Repair of Catheter-Related Femoral Artery Pseudoaneurysms is Impaired by Anticoagulation

Ultrasound-guided compression repair (UGCR) of catheter-related femoral artery pseudo aneurysms (CFAP) was retrospectively reviewed. Variables including etiology, size, location, age of pseudoaneurysm, depth and length of neck, coagulation status, number of attempts at compression, and total time of compression were studied. Five of 15 pseudoaneurysms were successfully occluded by use of UGCR. Reasons for failure included compression without occlusion (7), inability to arrest flow in the pseudoaneu rysm during compression (2), and inability of the patient to tolerate compression (1). Two patients who had pseudoaneurysms that we were unable to occlude on initial compression thrombosed their pseudoaneurysms spontaneously on follow-up examina tion. No patient (0/9) who was anticoagulated at the time of compression had a successful occlusion. All five patients with a normal coagulation profile at the time of compression were successfully occluded. One of these pseudoaneurysms recurred, however, after heparin was resumed. Size of pseudoaneurysm, depth or length of neck, time to presentation, or total time of compression did not predict success of UGCR. There were no complications in our series. UGCR is a safe, cost-effective treatment for patients with catheter-related femoral pseudoaneurysms and a normal coagulation profile.