Success rate of ultrasound-guided compression in management of femoral artery pseudoaneurysm following coronary artery angiography

Background: Iatrogenic femoral artery pseudoaneurysm, a rare but significant complication, could be managed by ultrasound-guided compression. This study decided to evaluate the success rate of this method and the risk factors associated with failure.Methods: In this cross-sectional study performed in two university hospitals, all patients who developed pseudoaneurysm of the femoral artery after coronary angiography for six years (2013 to 2018) and underwent ultrasound-guided compression by a vascular surgeon were included. Necessary information, including gender, age, body mass index (BMI), pseudoaneurysm neck diameter, diabetes, hypertension, smoking, anemia, and coronary heart disease, were collected. Then, the success rate of the treatment was evaluated, and the risk factors associated with failure were determined using the regression analysis.Results: Forty-five patients (25 males and 20 females) with a mean age of 61.6 years developed the complication. Treatment was successful in 32 patients (71.1%) but failed in 13 patients (28.9%). Logistic regression results showed that BMI ≥ 30 kg/m2 (OR (odds ratio)= 5.7, 95% CI: 1.2 to 26.6, P= 0.02) and pseudoaneurysm neck diameter of ≥ 4 mm (OR= 6.3, 95% CI: 1.3 to 31.3, P= 0.02) significantly associated with treatment failure. Conclusion: Obesity (BMI ≥ 30) and neck diameter of ≥ 4 mm were significant risk factors for failure of ultrasound-guided compression of femoral artery pseudoaneurysm. Taking more precautions in patients who have these two risk factors may help reduce the failure rate of this technique.