| Spontaneous closure of selected iatrogenic pseudoaneurysms and arteriovenous fistulae. | |
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MedLine Citation:
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PMID: 9152307 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: We report our approach to the management of postcatheterization femoral artery pseudoaneurysms and arteriovenous fistulae in an attempt to determine the frequency of spontaneous resolution of selected lesions. METHODS: We studied 196 pseudoaneurysms, 81 arteriovenous fistulae, and 9 combined lesions that were identified by duplex scan. Indications for immediate surgical repair included pseudoaneurysm greater than 3 cm, enlarging hematoma, pain, groin infection, nerve compression, limb ischemia, concomitant surgical procedure, and patient refusal or inability to comply with follow-up. All other lesions were observed. RESULTS: One hundred thirty-nine patients underwent prompt surgical repair, and 147 patients were initially managed without operation. There were no limb-threatening complications associated with nonoperative management in this subset of patients. Eighty-six percent of the lesions being observed resolved spontaneously within a mean of 23 days, whereas 14% required surgical closure for a variety of reasons (at a mean of 111 days after the initial diagnosis). There was no statistically significant difference in the rate of spontaneous pseudoaneurysm closure (89%) as opposed to fistulae (81%) (p < 0.17). By life-table analysis, 90% of selected pseudoaneurysms had resolved by 2 months. Patients selected for observation underwent an average of 2.6 duplex scans per patient versus 1.4 scans per patient for those treated with immediate surgery (p < 0.01). CONCLUSION: The natural history of stable pseudoaneurysms and arteriovenous fistulae is benign and frequently results in spontaneous resolution, which allows properly selected patients to be managed without operation. |
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Authors:
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B Toursarkissian; B T Allen; D Petrinec; R W Thompson; B G Rubin; J M Reilly; C B Anderson; M W Flye; G A Sicard |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Journal of vascular surgery Volume: 25 ISSN: 0741-5214 ISO Abbreviation: J. Vasc. Surg. Publication Date: 1997 May |
Date Detail:
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Created Date: 1997-06-06 Completed Date: 1997-06-06 Revised Date: 2012-10-03 |
Medline Journal Info:
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Nlm Unique ID: 8407742 Medline TA: J Vasc Surg Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 803-8; discussion 808-9 Citation Subset: IM |
Affiliation:
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Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Analysis of Variance Aneurysm, False / etiology, surgery, ultrasonography* Arteriovenous Fistula / etiology, surgery, ultrasonography* Catheterization, Peripheral / adverse effects Chi-Square Distribution Female Femoral Artery / injuries, surgery, ultrasonography* Humans Iatrogenic Disease* Life Tables Male Remission, Spontaneous Time Factors Ultrasonography, Doppler, Color |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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