[B-Flow: sonographic assessment and therapy for femoral artery pseudoaneurysm]

Abstract

Purpose: To evaluate the diagnostic accuracy of femoral artery pseudoaneurysm by B-flow, a new ultrasound method and the outcome of compression treatment.

Material and methods: 700 patients with radiological interventions (300 DSA, 355 PTA, 45 thrombolysis) have been examined by vascular ultrasound for possible bleeding at the puncture site to rule out pseudoaneurysms. The new B-flow ultrasound with a multi-frequency probe was used besides color-coded Doppler (CCD) and power Doppler (PD).

Results: No pseudoaneurysm was found in patients with diagnostic angiography and thrombolysis. In 25 of 355 patients a pseudoaneurysm was detected after PTA in 8 of them in the common and in 17 in the superficial femoral artery. The diameters were 1.5 to 4.5 cm, 3 cm on average. By ultrasound compression treatment of 20 minutes on the average 23 out of 25 pseudoaneurysms were occluded without any further complication. In B-flow the lesion of the vessel wall, the flow in the fistula and in the sack of the pseudoaneurysm were better demonstrated and without artifacts compared to both other methods. This makes treatment by compression much easier, first of all because remaining flow phenomena and the progression of intracavitary thrombosis can be controlled.

Conclusion: The newly developed B-flow detects both slow and fast flow phenomena. Visualisation of the fistula canal and the aneurysm sack is more reliable and examiner-independent than other Doppler methods such as CCD and PD. This allows better compression treatment of the fistula canal.