Affiliations: [a] Department of Cardiology, Pulmonology, and Vascular Medicine, University Duesseldorf, Medical Faculty, Duesseldorf, Germany
| [b] Cardiovascular Research Institute Duesseldorf (CARID)Duesseldorf, Germany
| [c] Department of Clinical and Experimental Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| [d] Department of Vascular Medicine, Surrey and Sussex NHS Healthcare Trust, Redhill, United Kingdom
Correspondence:
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Corresponding author: Manuel Stern, MD., Department of Cardiology, Vascular Medicine, and pulmonary Diseases, University Duesseldorf, Medical Faculty, Moorenstreet. 5 40225 Duesseldorf, Germany. Tel.: +49 211 81 04424; Fax: +49 211 81 18812; E-mail: [email protected].
Note: [1] M. Stern and J. Schremmer contributed equally to this paper.
Abstract: BACKGROUND:Femoral pseudoaneurysm (PSA) is a severe complication after endovascular procedures. Ultrasound-guided manual compression (MC) and percutaneous thrombin injection (TI) are frequently used treatments. MC is less effective, TI may cause thromboembolic events. OBJECTIVE:Up to date, there is no data regarding impairment of microvascular tissue perfusion after PSA treatment. METHODS:In this single-center, prospective study 22 patients with PSA were included. We compared macro- and microcirculatory perfusion in the treated and untreated leg at baseline before, after and one day after treatment. Leg perfusion was assessed with ultrasound and ankle-brachial index (ABI). Microcirculatory perfusion of the feet was measured with a near-infrared spectroscopy (NIRS) camera generating StO2-tissue-maps. RESULTS:Successful PSA thrombosis was achieved in 16 (100%) patients in TI group and in 4 (66.7%) patients in MC group. There was no evidence of arterial thrombi on ultrasound and the ABI did not differ between groups. NIRS StO2-tissue-maps of the feet showed no significant difference in both groups concerning the treated (p = 0.121) or the untreated (p = 0.198) leg during follow up. CONCLUSIONS:In this small exploratory study, there was no evidence of micro- and macrovascular tissue perfusion impairment after treatment of postcatheterization femoral pseudoaneurysm with thrombin injection underscoring the safety of this approach.
