Ultrasound assessment of the morphology of iatrogenic pseudoaneurysms as a prognostic factor in compression therapy

Background: Limiting inconvenience of compression therapy of iatrogenic pseudoaneurysm (IPA) seems to be a good reason to establish additional criteria for assessment of the probability of achieving embolization of a pseudoaneurysm after conventional treatment. As a result, patients who currently are qualified for ineffective compression therapy could be originally selected for operative treatment. Material/Methods: The study group comprised 155 patients with pseudoaneurysms resulting from catheterization of the femoral artery. In all cases, IPA morphology was assessed in duplex Doppler ultrasound and its elements linked with the efficacy of compression therapy. Results: The following parameters of IPA morphology result in significantly worse prognosis for successful conservative treatment with compression: diameter (> 30 mm), cavity volume (> 30 cm3), IPA's multiloculation, lack of progression in thrombosis of IPA cavity, the neck arising from the external iliac artery or the profunda femoris artery as well as from the posterior or lateral wall of any artery. Conclusions: Skipping compression therapy and favoring primary operative treatment should be considered in all these cases. In this way, the number of patients who undergo unsuccessful conservative treatment in a course of several days will be significantly reduced, contributing to a decrease in costs of the therapy and minimizing inconvenience experienced by patients.