Pseudoaneurisma de arteria femoral asociado a procedimiento endovascular en pacientes con ictus. Serie de casos

Macarena Marcos Osuna, Elena González Holgado, Maddi Llorente Olasagasti, Arantza López de Turiso López, Maite Martínez Zabaleta, Patricia de la Riva Juez
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Abstract

Background

Femoral artery access site complications are uncommon but likely to become more frequent with the increased use of endovascular procedures in stroke patients.

Aims

This study aims to describe the clinical, diagnosis and treatment features of a consecutive case series of femoral artery pseudoaneurysms (FAP).

Method

A retrospective case series was performed for consecutive patients diagnosed with FAP at our institution between January 2016 and January 2020. Variables regarding patient demographics, endovascular procedural features and FAP description, diagnosis, treatment and outcomes were included.

Results

We identified a total of nine cases in a 5-year period; six happened after acute endovascular therapy for stroke, two after diagnostic arteriography and one after subarachnoid hemorrhage related ruptured aneurysm embolization. Most patients experienced local symptoms but in three cases the FAP was incidentally discovered during the stroke diagnostic study. Only one of the patients experienced severe anemia related to the FAP. Regarding treatment, local compression and patient rest was enough in two cases, thrombine percutaneous injection was used in three patients and open surgery in three. Nurse reports included evaluation of the groin status (pain, lump, and bruise) prior to the FAP diagnosis in six patients.

Conclusions

The clinical presentation of FAP after endovascular procedure is heterogeneous and its diagnosis and management may be challenging. Systematic assessment of the groin after EP in stroke patients could help in prompt diagnosis and treatment of this complication.

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中风患者血管内手术相关股动脉假动脉瘤。案例系列
背景股动脉入路部位并发症并不常见,但随着脑卒中患者越来越多地使用血管内手术,这种并发症可能会变得更加频繁。目的本研究旨在描述股动脉假性动脉瘤(FAP)连续病例系列的临床、诊断和治疗特点。方法对2016年1月至2020年1月期间在我院确诊为FAP的连续患者进行回顾性病例系列研究。结果 我们在 5 年内共发现 9 例患者,其中 6 例发生在卒中的急性血管内治疗后,2 例发生在动脉造影诊断后,1 例发生在蛛网膜下腔出血相关的动脉瘤破裂栓塞后。大多数患者都有局部症状,但有三例患者是在中风诊断研究中偶然发现 FAP 的。只有一名患者出现了与 FAP 相关的严重贫血。在治疗方面,2 例患者只需局部按压和休息即可,3 例患者采用了经皮注射血栓,3 例患者采用了开放手术。结论 血管内手术后 FAP 的临床表现多种多样,其诊断和治疗可能具有挑战性。对脑卒中患者进行 EP 术后腹股沟系统评估有助于及时诊断和治疗该并发症。
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