Evaluation of risk factors associated with femoral pseudoaneurysms after cardiac catheterization

• Published in: Journal of vascular surgery Vol. 43; no. 3; pp. 520 - 524
• Main Authors: Ates, Mehmet, Sahin, Sinan, Konuralp, Cuneyt, Gullu, Umit, Cimen, Serdar, Kizilay, Mehmet, Gunay, Rafet, Sensoz, Yavuz, Akcar, Murat
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.03.2006; Elsevier
• Subjects: Aneurysm, False - etiology; Aneurysm, False - surgery; Biological and medical sciences; Body Mass Index; Cardiac Catheterization - adverse effects; Cardiac Catheterization - methods; Coronary Disease - complications; Diabetes Complications; Diseases caused by cestodes; Echinococcoses; Female; Femoral Artery; Helminthic diseases; Humans; Hypertension - complications; Infectious diseases; Male; Medical sciences; Middle Aged; Neurology; Parasitic diseases; Risk Factors; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Vascular diseases and vascular malformations of the nervous system; Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels; Cardiovascular disease; Catheterization; False aneurysm; Surgery; Risk factor
• ISSN: 0741-5214; 1097-6809
• DOI: 10.1016/j.jvs.2005.11.009

Femoral pseudoaneurysm (FPA) is one of the common complications of percutaneous catheterization procedures performed via the femoral artery. The aim of this research was to evaluate factors associated with FPA of sufficient clinical significance that they required surgical treatment after diagnostic or interventional cardiac catheterization. We evaluated 41,322 transfemoral catheterization procedures performed in our center within 7 years. Among all procedures, 630 FPAs developed that required surgical repair. Eighty-five cases were managed by compression with duplex guidance. As a case-control group, 1260 patients were selected from the patients who had been catheterized during the same time period but did not develop FPA. Two controls were selected for each study patient, matched according to age, sex, and catheterization day. Body mass index, hypertension, diabetes mellitus, catheter diameter, coronary artery disease, atherosclerosis, and number of cases performed per day in a particular room were evaluated as risk factors by using multivariate techniques. Femoral pseudoaneurysm required operative repair in 1.1% (n = 398) of patients who underwent cardiac catheterization for diagnostic purposes and in 4.7% (n = 232) of patients after cardiac interventional procedures. Factors found to be independently predictive of FPA were hypertension ( P = .011; odds ratio, 1.52), diabetes mellitus ( P = .035; odds ratio, 1.11), coronary artery disease ( P = .022; odds ratio, 1.21), larger (≥28 kg/m 2) body mass index ( P < .001; odds ratio, 2.21), larger number of cases (≥18) performed per day in a particular room ( P < .001; odds ratio, 2.39), and larger (≥7F) catheter diameter ( P < .001; odds ratio, 2.82). Due to the development of technology and experience, more and more diagnostic and interventional catheterization procedures are performed on a daily basis. In our study, a high volume of cases in a particular room and use of large catheters were important risk factors for FPA complications. When these situations are combined with other risk factors (such as obesity, diabetes mellitus, hypertension, and arteriosclerosis), giving particular attention to local compression therapy would be more crucial to decrease the FPA rate.