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CC BY-NC-ND 4.0 · Indian J Radiol Imaging
DOI: 10.1055/s-0044-1793810
Original Article

Transaneurysmal Suturing of Pseudoaneurysm Neck: Novel and Not a Pseudo-Technique for Treatment of Complicated Femoral Pseudoaneurysm

Niraj Kumar
1   Department of Interventional Radiology, Sarvodaya Hospital and Research Centre, Faridabad, Haryana, India
,
Chandan Kumar Pal 
2   Department of Radiodiagnosis, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
,
Somsharan Shankerappa Betgeri
3   Department of Interventional Radiology, Caritas Hospital, Kottayam, Kerala, India
,
Amar Mukund 
4   Department of Interventional Radiology, Institute of Liver and Biliary Sciences, New Delhi, India
› Author Affiliations Funding None.
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Abstract

Introduction Femoral pseudoaneurysm is one of the common complications following femoral artery catheterization. It poses a significant morbidity and a nonsurgical technique with the utmost low complication risk is warranted. Various methods have been used to treat these pseudoaneurysms including manual compression, ultrasound-guided compression, and percutaneous injection of thrombin or glue. Various novel methods are also being used to treat the pseudoaneurysms, including angioseal closure device, vascular plugs, etc. Cirrhosis poses a separate challenge with deranged coagulation and hyperfibrinolysis, making traditional methods, which are dependent on patients' coagulation cascade, less effective.

Materials and Methods We used a novel technique to treat the complicated femoral pseudoaneurysm using a suture-mediated closure device, Perclose ProGlide system (Abbott Vascular, California, United States). The transaneurysmal approach was used in seven patients. All the patients had acute or chronic liver disease with deranged coagulation. Six patients had femoral arterial access for angiographic procedure while one had a femoral line for intensive care unit monitoring. Compression was done in all the patients, but failed. Percutaneous injection of thrombin was done in two patients.

Results Technical success was achieved in 7/7 (100%) patients. There was instantaneous thrombosis of the pseudoaneurysm, which was confirmed the next day by ultrasound. There were no procedure-related complications.

Conclusion Transaneurysmal closure of the femoral pseudoaneurysm using suture-mediated closure device is a novel and effective, minimally invasive bedside technique that can be used in patients with deranged coagulation.

Keywords

femoral pseudoaneurysm - transaneurysmal - vascular closure device - ProGlide

Note

This study was previously presented at ISVIR annual conference, January 13, 2024, Jaipur, Rajasthan, India.


Authors' Contributions

N.K.: concepts, design, data acquisition, data analysis, literature search, and manuscript preparation.


C.K.P.: concepts, data analysis, literature search, and manuscript editing.


S.S.B.: data acquisition and manuscript review.


A.M.: concepts, design, data acquisition, data analysis, and manuscript review.


Guarantor: A.M.




Publication History

Article published online:
11 December 2024

© 2024. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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