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Femoral pseudoaneurysms post-cardiac catheterization surgically treated: evolution and prognosis

Division of Vascular Surgery, Valladolid University Hospital, Valladolid, Spain

*Corresponding author. C/Ramón y Cajal n°3, 47005, Valladolid, Spain. Tel.: +34-686754618; fax: +34-983420000.

E-mail address: esannorberto{at}hotmail.com (EM. San Norberto García).

Objectives: To analyze the postoperative complications of patients who have undergone surgical repair of femoral pseudoaneurysm after cardiac catheterization. Design: Prospective study. Materials: Cardiovascular risk factors, related to surgery and cardiac catheterization were collected prospectively in 79 patients from 2003 to 2006 in Valladolid University Hospital. The indications of surgery included necrosis of adjacent soft tissue, rapid growth, infection, bleeding, hemodynamic instability or failure of the percutaneous treatment (US-guided compression and US-guided percutaneous thrombin injection). Methods: Patient and management related predictors for 30-day outcome were analyzed. Results: Fifty-six patients (56/79, 71%) experienced some type of postoperative complication, the most frequent being the need for a transfusion. Infection (15/79, 19%) and dehiscence of the surgical wound (10/79, 12.7%) were the other two most common complications. The mortality related to the intervention was 3.8% (3/79). The mean hospital stay was 32.5 days (±28.4 days). Significant risk factors in logistic regression model were gender (P=0.023, OR=9.66), 70 years old (P=0.049, OR=0.15) and the concurrent use of anticoagulation or antiplatelet therapy after the cardiac catheterization (P=0.005, OR=0.03). Conclusion: Patients who undergo surgical treatment of femoral pseudoaneurysm post-cardiac catheterization experience a high postoperative morbidity and hospital stay. Factors such as female gender, age over 70 years and treatment with anticoagulants or antiplatelets increase the postoperative morbidity. A seasonal influence was appreciated, with a higher frequency during the summer period.

Key Words: Pseudoaneurysm; Cardiac catheterization; Surgical risk

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