ISSN: 1899-0967
Polish Journal of Radiology
Established by prof. Zygmunt Grudziński in 1926 Sun
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1/2021
vol. 86
 
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Interventional radiology
abstract:
Original paper

Risk and prognostic factors of post-catheterization pseudoaneurysm

Kenkichi Michimoto
1
,
Shinsuke Takenaga
1
,
Yo Matsui
1
,
Keitaro Enoki
1
,
Yosuke Nozawa
1
,
Takahiro Higuchi
1
,
Hiroshi Sakamoto
2
,
Yasuto Noda
3
,
Satoru Morooka
3

1.
Department of Radiology, Fuji City General Hospital, Japan
2.
Department of Cardiology, Fuji City General Hospital, Japan
3.
Department of Neurosurgery, Fuji City General Hospital, Japan
Pol J Radiol 2021; 86: e511-e517
Online publish date: 2021/09/02
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Introduction
To evaluate the risk and prognostic factors of post-catheterization pseudoaneurysm (PPA).

Material and methods
To identify the risk factors for PPA occurrence, clinical findings were compared between 22 consecutive patients with radiologically confirmed PPAs (PPA group) and 300 randomly extracted patients without PPA, who underwent transarterial angiography or intervention (sample group) between 1 January 2015 and 31 March 2020. The PPA group was further divided into those treated successfully with mechanical compression (group A) and those requiring ultrasound-guided thrombin injection after compression failed (group B). Univariate and multivariate analyses were used to compare patient demographics, preoperative laboratory findings, procedure details, PPA diameter, and time interval between the procedure and compression between groups A and B to evaluate the prognostic factors of PPA.

Results
The PPA group demonstrated significantly elevated prothrombin time international normalized ratios (PT/INR) (odds ratio [OR]: 6.27, 95% confidence interval [CI]: 2.020-19.5; p = 0.00151) and more frequent popliteal access (OR: 14.2, 95% CI: 1.040-195.0; p = 0.0467) compared to the sample group, and radial access decreased the risk of PPA (OR: 0.382, 95% CI: 0.0148-0.987; p = 0.0468). One of the 22 PPAs resolved spontaneously, and 11 others (52.4%) were successfully treated by mechanical compression. An interval exceeding 24 hours between the procedure and compression was the only significant prognostic factor (p = 0.0281) between groups A and B.

Conclusions
Elevated PT/INR and popliteal access may predispose patients to PPA; close consideration of the site of access may lower the risk of refractory PPA.

keywords:

catheterization, prognostic factor, pseudoaneurysm, risk factor




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