Successful conservative management of iatrogenic femoral arterial trauma

Steven P. Rivers, Elizabeth Slass Lee, Ross T. Lyon, E. Scott Monrad, Tom Hoffman, Frank J. Veith

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

We have developed a protocol for nonoperative management of pseudoaneurysms and arteriovenous fistulas secondary to cardiac catheterization. Hemodynamically stable patients were placed at bed rest and underwent serial physical examination, hematocrit, and duplex ultrasonography for a minimum of three days prior to discharge and subsequently as outpatients. Sixteen initially stable patients out of 56 with femoral artery catheter trauma managed over a four-year period underwent deliberate conservative management. Their lesions included six arteriovenous fistulas, seven pseudoaneurysms, and three patients with both complications. All but one of the pseudoaneurysms resolved spontaneously within four weeks regardless of initial size or associated arteriovenous fistula. One patient receiving anticoagulant therapy required surgery for bleeding after a three-day period of observation of a pseudoaneurysm. Six of the nine arteriovenous fistulas also resolved within the initial period of observation. The remaining three have been followed for four to 20 months and have remained asymptomatic. Nonoperative therapy of catheter-related femoral artery trauma is both safe and effective. Conservative management avoids potential wound complications associated with dissection through surrounding hematoma as well as the additional hospitalization required for postoperative care. We recommend a period of observation for all hemodynamically stable patients with catheter-induced pseudoaneurysms and arteriovenous fistulas of the femoral vessels, with surgery reserved for hemorrhage, expanding masses, or compromised cardiac output.

Original languageEnglish (US)
Pages (from-to)45-49
Number of pages5
JournalAnnals of Vascular Surgery
Volume6
Issue number1
DOIs
StatePublished - Jan 1992

Fingerprint

False Aneurysm
Arteriovenous Fistula
Thigh
Wounds and Injuries
Catheters
Observation
Femoral Artery
Hemorrhage
Bed Rest
Postoperative Care
Cardiac Catheterization
Hematocrit
Hematoma
Cardiac Output
Anticoagulants
Physical Examination
Dissection
Ultrasonography
Hospitalization
Outpatients

Keywords

  • arteriovenous fistula
  • catheterization
  • femoral artery
  • Pseudoaneurysm
  • trauma

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Successful conservative management of iatrogenic femoral arterial trauma. / Rivers, Steven P.; Lee, Elizabeth Slass; Lyon, Ross T.; Monrad, E. Scott; Hoffman, Tom; Veith, Frank J.

In: Annals of Vascular Surgery, Vol. 6, No. 1, 01.1992, p. 45-49.

Research output: Contribution to journalArticle

Rivers, Steven P. ; Lee, Elizabeth Slass ; Lyon, Ross T. ; Monrad, E. Scott ; Hoffman, Tom ; Veith, Frank J. / Successful conservative management of iatrogenic femoral arterial trauma. In: Annals of Vascular Surgery. 1992 ; Vol. 6, No. 1. pp. 45-49.
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