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Outcomes of Iatrogenic Femoral Artery Lesions - Treatment Results Valuation

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Łukasiewicz A., Hryncewicz W., Rychter M., Molski S.
Polish Journal of Surgery
|
2009
|
vol. 81
|
issue 4
172-179
EN
Percutaneous cardiac interventions are nowadays the most common cause of the femoral artery injury. In these cases, surgical intervention was for many years considered the treatment of choice. Satisfactory results of conservative and minimally invasive treatment has changed the state of art.The aim of the study was the analysis of treatment results in patients with iatrogenic femoral aneurysm.Material and methods. In the period of 3 years between 2004 and 2006 in 66 patients an iatrogenic, spure femoral artery aneurysm was recognized. There were 36 women and 30 men in this group. The mean age was 68.8 years. All patients were included prospectively in the study. According to aneurysm morphology, compression pliability and patient choice 45 individuals were assigned to OT group, remaining 21 were treated conservatively: US-guided compression in all patients and thrombin injection if compression failed.Results. There was one death in OT group due to underlying coronary disease and in our opinion unrelated to surgical treatment. Other major adverse events were one postoperative stroke in OT group and superficial femoral artery thrombosis in NT group. 8 patients experienced minor events and they all were operative wound complications. No other complications were observed in NT group. Post procedural stay was longer for the OT group (8.7 vs 3.8 days, p<0.05). Length of hospital stay was also significantly correlated with presence of complications (5.5 days for patients without complications and 16.9 days for the complicated cases, p<0.001). The procedure was successful in 95.2% and 100% in the groups of NT and OT respectively.Conclusions. Utilized criteria of patients' assignment to conservative and operative treatment allowed plausible treatment results. OT and complications significantly increase the length of hospitalization. It is mandatory to remember of possible thrombotic complications related to thrombin injections.
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