Hasan YERLİ, Safiye GÜREL, Hakan ÖZDEMİR, Murat ÖZDEMİR, Cem YÜCEL, Şule KOŞAR

US-guided compression repair in iatrogenic pseudoaneurysms

Amaç: Ekstremite arter kateterizasyonu sonrasında gelişen psödoanevrizma olgularında, ultrasonografi eşliğinde kompresyon tedavisinin etkinliğinin değerlendirilmesi. Metod: Bir yıllık dönem içerisinde, kardiyak kateterizasyon sonrasında gelişen ondört psödoanevrizma olgusunda, Fellmeth tarafından tanımlanan teknikle ultrasonografi eşliğinde kompresyon tedavisi uygulandı. Brakial arter psödoanevrizmalı bir olguda spontan tromboz gözlendi. Tüm olgular, işlemden 24 saat sonra yeniden renkli Doppler ultrasonografi ile değerlendirildi. Bulgular: Olguların onüçünde (% 92), ultrasonografi eşliğinde kompresyon tedavisi ile başarı sağlandı. Bu olgulardan kompresyon sırasında antikoagülan tedavi alan iki tanesinde işlemden bir gün ve üç gün sonra rekürrens saptandı. Bu olgulara, 'ultrasonografi eşliğinde kompresyon' tedavisi tekrarlandı. Kooperasyon sağlanamayan bir olguda ise işlem başarısız oldu. İşlem sırasında ve takip süresince herhangi bir komplikasyon ile karşılaşılmadı. Sonuç: Ultrasonografi eşliğinde kompresyon tedavisi, psödoanevrizmaların tedavisinde etkin ve güvenli bir yöntemdir. İşlem öncesinde ve sırasında hasta ile iyi kooperasyon kurulması, antikoagülan tedavi alan ve multilobe psödoanevrizmalı olgularda kompresyon süresinin uzun tutulması ya da antikoagülan kesildikten sonra işlemin tekrarlanması, başarı oranım artıran faktörlerdir

İatrojenik psödoanevrizmaların US kılavuzluğunda kompresyon tedavisi

Purpose: To evaluate the efficacy of ultrasound-guided compression repair in patients with pseudoaneurysms due to extremity artery catheterizations. Materials and Methods: Over a one-year period, fifteen patients with fourteen femoral pseudoaneurysms and one brachial pseudoaneurysm, which developed after cardiac catheterizations, were examined with color Doppler imaging. All of the patients were reevaluated with color Doppler imaging within 24 hours of the procedure. Results: In the initial attempt, ultrasound-guided compression repair was successful in thirteen (92%) patients. In one patient with brachial pseudoaneurysm, spontaneous thrombosis was demonstrated. Two recurrences were encountered, one and three days after the procedure. Recompression was performed successfully without further problems. Adequate compression could not be achieved in an uncooperative patient. No complications were observed during or after the procedures. Conclusion: Ultrasound-guided compression repair is a safe and effective method for the treatment of pseudoaneurysms. To achieve high success rates, good cooperation has to be obtained from the patient. In patients with anticoagulated and multiloculated pseudoaneurysms longer compression periods or recompression after cessation of anticoagulation may improve the success rates.

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