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Percutaneous instillation of physiological saline solution for the treatment of femoral pseudoaneuryms

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Summary

Objective

To investigate the efficacy of para-aneurysmal saline injection for closure of postcatheterization pseudo-aneurysm (PA) at the vascular access site.

Methods

Fifty-one consecutive patients with postcatheterization PA at the vascular access site were included to undergo percutaneous para-aneurysmal saline injection. In case of technical failure the day after, PA were treated by bovine thrombin injection. Anatomical properties of the PA were recorded as were details to injection.

Results

Initially all patients exhibited success which was reduced to 43 % at day one. A saline volume of median 7 ml (interquartile range 6–8 ml) has been injected. The amount of injected saline was not different in patients with and without treatment success at day one (P = 0.6). Several anatomical properties of the PA exhibited marked differences in patients with or without success. The length (10.3 mm (7.8–12.0) vs. 12.5 mm (10.3–15.0); P = 0.009) and the angulation (110° (100–118) vs. 140° (129–146); P < 0.001) of the fistula/vessel axis was statistically different between groups. The peak systolic velocity failed to show significance with a tendency to higher values in the ineffective study group (P = 0.07). No peripheral complications occurred.

Conclusion

Para-aneurysmal saline injection may be a therapeutic alternative to percutaneous thrombin injection in patients exhibiting favorable anatomical properties.

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Authors and Affiliations

  1. Department of Internal Medicine II, Division of Angiology, Vienna General Hospital—Medical School, Währinger Gürtel 18–20, 1090, Vienna, Austria

    Georgiana-Aura Giurgea, Matthias Hoke, Schila Sabeti-Sandor, Erich Minar &  Wolfgang Mlekusch

  2. Department of Vascular Surgery, Wilhelminenspital Vienna, Vienna, Austria

    Irene Mlekusch

  3. Clinical Pharmacology and Pharmacoepidemiology, University Heidelberg, Heidelberg, Germany

    Alexandra Carls

Authors
  1. Georgiana-Aura Giurgea
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  2. Irene Mlekusch
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  3. Matthias Hoke
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  5. Schila Sabeti-Sandor
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  6. Erich Minar
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  7. Wolfgang Mlekusch
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Correspondence to Wolfgang Mlekusch.

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Conflict of interest

G.-A. Giurgea, I. Mlekusch, M. Hoke, A. Carls, S. Sabeti-Sandor, E. Minar, and W. Mlekusch declare that there are no actual or potential conflicts of interest in relation to this article.

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Giurgea, GA., Mlekusch, I., Hoke, M. et al. Percutaneous instillation of physiological saline solution for the treatment of femoral pseudoaneuryms. Wien Klin Wochenschr 128, 421–425 (2016). https://doi.org/10.1007/s00508-016-0979-8

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  • DOI: https://doi.org/10.1007/s00508-016-0979-8

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