Obliteration of femoral pseudoaneurysm complicating coronary intervention by direct puncture and permanent or removable coil insertion

Abstract

We report on percutaneous obliteration of femoral pseudoaneurysm complicating percutaneous coronary interventions in 6 patients. Our findings suggest that permanent or transient direct coil insertion may be an useful alternative in the treatment of pseudoaneurysm hi patients who do not respond to mechanical compression.

Groin complications after coronary stent implantation have been reduced with the change in the antithrombotic regimens. The rate of severe groin bleeding or femoral pseudoaneurysm has been reported between 3.5% and 26% with the first aggressive anticoagulation recommendations,[ 1 , 2 , 3 ] and still remains around 0.8% to 2.2% in recent publications in which antiplatelet therapy alone,[ 4 , 5 , 6 ] or in combination with low-molecular weight heparin,[ 7 ] has been used. Although the present incidence of this complication is low, when it occurs the patient may require a long period of bed rest and surgery, which increases the hospital stay and the cost of the procedure. In this study we describe a method of percutaneous treatment of this femoral complication in 6 patients, 64 ± 10 years old, after percutaneous coronary intervention (5 by stent implantation and 1 by balloon angioplasty) through an 8Fr guiding catheter.