Clinical Outcome of Surgical Treatment of Giant Femoral Artery Pseudoaneurysms

Surgical Outcomes of Giant Femoral Artery Pseudoaneurysms

Authors

  • Adeel Mushtaq Department of Vascular Surgery, Doctors Hospital and Medical Centre, Lahore, Pakistan
  • Amir Usman Department of Surgery, University College of Medicine and Dentistry, University of Lahore, Lahore, Pakistan
  • Ahmad Naeem Akhtar Department of Surgery, Lahore General Hospital, Lahore, Pakistan
  • Nazia Farooq Department of Hematology, Lahore Medical and Dental College, Lahore, Pakistan
  • Shahzad Naveed Jawaid Department of Surgery, Lahore General Hospital, Lahore, Pakistan
  • Shabbir Ahmed Department of Surgery, Bakhtawar Amin Medical and Dental College, Multan, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v5i08.1821

Keywords:

Femoral Artery Pseudoaneurysm, Drug Abusers, Giant Pseudoaneurysms

Abstract

Femoral artery was used as an access site for cardiovascular procedures and by IV drug abusers, Femoral Artery Pseudoaneurysm (FAP) was a common complication associated with these procedures. Objective: To evaluate clinical outcome of surgical repair of femoral artery pseudoaneurysms. Methods: The prospective study was conducted in Doctors Hospital, Lahore from October 2022 to October 2023.  The study included patients with giant femoral artery pseudoaneurysms who required surgical intervention. Data from a total of 50 patients were included in whom both peripheral vascular interventions and percutaneous cardiac catheterization was performed. Patients were followed up at 1-, 3-, 6- and 12 months postoperatively. SPSS version 23.0 was used for data analysis. Results: All patients underwent open surgical treatment. Of 50 patients, 25 (50%) had SFA pseudoaneurysm, 20 (40%) had CFA pseudoaneurysm and 5 (10%) had PFA pseudoaneurysm. The mean duration of clinical manifestations was 16.30 ± 7.74 days. Surgical repair was successful in all 50 (100%) patients and distal ischemia was fully resolved. There was no case of limb loss or post-operative mortality. One patient had an infection in the groin wound and had raised Total leucocyte count (TLC), which was resolved by early drainage and antibiotic treatment. Patients were followed up at 1, 3, 6, and 12 months and there were no signs of clinical or angiographic evidence of post-operative complications and changes in distal pulse. Conclusion: Surgical repair was first-line treatment for giant FAP. It was clinically feasible and has a high success rate and low complication rate.

References

Rajashekhar S and Kumar A. Predictors of Post-catheterization Femoral Artery Pseudoaneurysm. Indian Journal of Cardiovascular Disease in Women. 2023 Apr; 8(2): 126-30. doi: 10.25259/IJCDW_24_2023. DOI: https://doi.org/10.25259/IJCDW_24_2023

Muglia R, Marra P, Dulcetta L, Carbone FS, Bonaffini PA, Sironi S. US-guided percutaneous thrombin injection to treat non-femoral artery pseudoaneurysms: preliminary experience and review of the literature. La Radiologia Medica. 2023 Jan; 128(1): 125-31. doi: 10.1007/s11547-022-01576-4. DOI: https://doi.org/10.1007/s11547-022-01576-4

Michimoto K, Takenaga S, Matsui Y, Enoki K, Nozawa Y, Higuchi T et al. Risk and prognostic factors of post-catheterization pseudoaneurysm. Polish Journal of Radiology. 2021 Sep; 86: e511. doi: 10.5114/pjr.2021.109077. DOI: https://doi.org/10.5114/pjr.2021.109077

Hamamoto K, Nonaka T, Tamai K, Chiba E, Oyama-Manabe N, Suyama Y et al. Embolization of deep femoral artery aneurysm with a ligated proximal artery using the direct percutaneous puncture technique. Annals of Vascular Diseases. 2022 Dec; 15(4): 329-32. doi: 10.3400/avd.cr.22-00043. DOI: https://doi.org/10.3400/avd.cr.22-00043

Rammos C and Rassaf T. Insight in the treatment of iatrogenic femoral artery pseudoaneurysms. Vasa. 2021 May: 231–239. doi: 10.1024/0301-1526/a000939. DOI: https://doi.org/10.1024/0301-1526/a000939

Burke B, Adhikari S. Ultrasound-guided vascular procedures. In: The ultimate guide to point-of-care ultrasound-guided procedures. 1st Edition; 2020. 271-91. doi: 10.1007/978-3-030-28267-7_15. DOI: https://doi.org/10.1007/978-3-030-28267-7_15

Audeh A, Al-Ghadeer B, Al-Khaldi F. Surgical treatment strategies of iatrogenic giant femoral artery pseudoaneurysms. Journal of Vascular and Endovascular Surgery. 2017 Feb; 2(1): 5. doi: 10.21767/2573-4482.100037. DOI: https://doi.org/10.21767/2573-4482.100037

Witberg G, Tzalamouras V, Adams H, Patterson T, Roberts-Thomson R, Byrne J et al. Routine ultrasound or fluoroscopy use and risk of vascular/bleeding complications after transfemoral TAVR. Cardiovascular Interventions. 2020 Jun; 13(12): 1460-8. doi: 10.1016/j.jcin.2020.03.047. DOI: https://doi.org/10.1016/j.jcin.2020.03.047

Oneissi M, Sweid A, Tjoumakaris S, Hasan D, Gooch MR, Rosenwasser RH et al. Access-site complications in transfemoral neuroendovascular procedures: a systematic review of incidence rates and management strategies. Operative Neurosurgery. 2020 Oct; 19(4): 353-63. doi: 10.1093/ons/opaa096. DOI: https://doi.org/10.1093/ons/opaa096

Wu H, Zhang L, Zhang C, Xie B, Lou C, Liu Y et al. Non-Surgical treatment Versus Surgery for Iatrogenic Femoral Artery Pseudoaneurysms: Systematic Review and Meta-Analysis. Frontiers in Surgery. 2022 Jun; 9: 905701. doi: 10.3389/fsurg.2022.905701. DOI: https://doi.org/10.3389/fsurg.2022.905701

Kurzawski J, Zandecki L, Janion-Sadowska A, Piatek L, Jaroszynska A, Domagala S et al. Choosing a treatment method for post-catheterization pseudoaneurysms guided by the late to early velocity index. Scientific Reports. 2021 Aug; 11(1): 16678. doi: 10.1038/s41598-021-96062-8. DOI: https://doi.org/10.1038/s41598-021-96062-8

Zhao B, Zhang J, Ma J, Huang M, Li J, Ma X. Comparison of three different treatment methods for traumatic and Iatrogenic peripheral artery pseudoaneurysms. Orthopaedic Surgery. 2022 Jul; 14(7): 1404-12. doi: 10.1111/os.13315. DOI: https://doi.org/10.1111/os.13315

Sarioglu O, Capar AE, Belet U. Interventional treatment options in pseudoaneurysms: different techniques in different localizations. Polish Journal of Radiology. 2019 Aug; 84: e319. doi: 10.5114/pjr.2019.88021. DOI: https://doi.org/10.5114/pjr.2019.88021

Koza Y and Kaya U. Retrospective analysis of 120 cases of iatrogenic and traumatic peripheral arterial pseudoaneurysms. The Eurasian Journal of Medicine. 2020 Jun; 52(2): 180. doi: 10.5152/eurasianjmed.2019.18422. DOI: https://doi.org/10.5152/eurasianjmed.2019.18422

Quiroga E, Shalhub S, Tran NT, Starnes BW, Singh N. Outcomes of femoral artery ligation for treatment of infected femoral pseudoaneurysms due to drug injection. Journal of Vascular Surgery. 2021 Feb; 73(2): 635-40. doi: 10.1016/j.jvs.2020.05.074. DOI: https://doi.org/10.1016/j.jvs.2020.05.074

Osilama E, Satchell EK, Ballehaninna UK. Delayed ulnar artery pseudoaneurysm presentation after percutaneous cardiac intervention: A case report and review of the literature. Vascular. 2024 Mar: 17085381241238267. doi: 10.1177/17085381241238267. DOI: https://doi.org/10.1177/17085381241238267

Minici R, Paone S, Talarico M, Zappia L, Abdalla K, Petullà M et al. Percutaneous treatment of vascular access-site complications: A ten years' experience in two centres. CardioVascular and Interventional Radiology Endovascular. 2020 Dec; 3: 1-0. doi: 10.1186/s42155-020-00120-7. DOI: https://doi.org/10.1186/s42155-020-00120-7

Randimbinirina ZL, Rajaobelison T, Ratsimarisolo N, Rakotorahalahy RN, Randrianandrianina HF, Ahmad A, Ravalisoa ML et al. Management of Post-traumatic Peripheral Arterial Pseudoaneurysm in Antananarivo. European Journal of Clinical Medicine. 2021 Jul; 2(3): 134-8. doi: 10.24018/clinicmed.2021.2.3.84. DOI: https://doi.org/10.24018/clinicmed.2021.2.3.84

Yamazaki D, Fujihashi T, Amamizu H, Kobayashi T, Takahashi T. VIABAHN® Stent Graft Implantation for Iatrogenic Arteriovenous Fistula and Pseudoaneurysm of the Deep Femoral Artery. Case Reports in Cardiology. 2024; 2024(1): 3426669. doi: 10.1155/2024/3426669. DOI: https://doi.org/10.1155/2024/3426669

Yong L. Treatment of iatrogenic femoral pseudoaneurysm: case report and review of the literature. Journal of Surgery. 2022 Jan; 2(1): 1029.

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Published

2024-08-31
CITATION
DOI: 10.54393/pjhs.v5i08.1821
Published: 2024-08-31

How to Cite

Mushtaq, A., Usman, A., Akhtar, A. N., Farooq, N., Jawaid, S. N., & Ahmed, S. (2024). Clinical Outcome of Surgical Treatment of Giant Femoral Artery Pseudoaneurysms: Surgical Outcomes of Giant Femoral Artery Pseudoaneurysms. Pakistan Journal of Health Sciences, 5(08), 166–169. https://doi.org/10.54393/pjhs.v5i08.1821

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