Incidence of and predisposing factors for pseudoaneurysm formation in a high-volume cardiovascular center

• Published in: PloS one 2021-08, Vol.16 (8), p.e0256317-e0256317
• Main Authors: Sarkadi, Hunor, Csőre, Judit, Veres, Dániel Sándor, Szegedi, Nándor, Molnár, Levente, Gellér, László, Bérczi, Viktor, Dósa, Edit
• Format: Article
• Language: English
• Subjects: Aged; Aneurysm, False - epidemiology; Aneurysm, False - etiology; Aneurysm, False - pathology; Anticoagulants; Archives & records; Arteries; Asymptomatic; Automation; Biology and Life Sciences; Blood; Blood circulation disorders; Brachial Artery - physiopathology; Brachial Artery - surgery; Cardiovascular system; Care and treatment; Complications and side effects; Compression; Coronary artery; Diagnosis; Endovascular Procedures - adverse effects; Erythrocytes; Female; Femoral artery; Femoral Artery - physiopathology; Femoral Artery - surgery; Health risks; Heart; Hematocrit; Hematoma; Hemoglobin; Humans; Lower Extremity - physiopathology; Lower Extremity - surgery; Male; Medical records; Medicine and Health Sciences; Middle Aged; Minimally invasive surgery; Patient outcomes; Patients; Pseudoaneurysm; Punctures - adverse effects; Risk factors; Thrombin; Treatment Outcome; Ultrasonic imaging; Ultrasonography, Interventional - adverse effects; Ultrasound; Vascular Closure Devices - adverse effects; Veins & arteries
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0256317

To evaluate factors associated with pseudoaneurysm (PSA) development. Between January 2016 and May 2020, 30,196 patients had invasive vascular radiological or cardiac endovascular procedures that required arterial puncture. All patients with PSA were identified. A matched (age, gender, and type of the procedure) control group of 134 patients was created to reveal predictors of PSA formation. Single PSAs were found in 134 patients. Fifty-three PSAs developed after radiological procedures (53/6555 [0.8%]), 31 after coronary artery procedures (31/18038 [0.2%]), 25 after non-coronary artery cardiac procedures (25/5603 [0.4%]), and 25 due to procedures in which the arterial puncture was unintended. Thirty-four PSAs (25.4%) were localized to the upper extremity arteries (vascular closure device [VCD], N = 0), while 100 (74.6%) arose from the lower extremity arteries (VCD, N = 37). The PSA prevalence was 0.05% (10/20478) in the radial artery, 0.1% (2/1818) in the ulnar artery, 1.2% (22/1897) in the brachial artery, and 0.4% (99/22202) in the femoral artery. Treatments for upper and lower limb PSAs were as follows: bandage replacement (32.4% and 14%, respectively), ultrasound-guided compression (11.8% and 1%, respectively), ultrasound-guided thrombin injection (38.2% and 78%, respectively), and open surgery (17.6% and 12%, respectively). Reintervention was necessary in 19 patients (14.2%). The prevalence of PSA for the punctured artery with and without VCD use was 37/3555 (1%) and 97/27204 (0.4%), respectively (OR, 2.94; 95% CI, 1.95-4.34; P