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Review
. 2022 Jun 8:9:905701.
doi: 10.3389/fsurg.2022.905701. eCollection 2022.

Non-Surgical treatment Versus Surgery for Iatrogenic Femoral Artery Pseudoaneurysms: Systematic Review and Meta-Analysis

Haoliang Wu  1   2 , Liwei Zhang  1 , Cong Zhang  1 , Boao Xie  1 , Chunyang Lou  1 , Yuanfeng Liu  1 , Hualong Bai  1   2
Affiliations
Review

Non-Surgical treatment Versus Surgery for Iatrogenic Femoral Artery Pseudoaneurysms: Systematic Review and Meta-Analysis

Haoliang Wu et al. Front Surg. .

Abstract

Objectives: This study compared results of non-surgical treatment (compression and ultrasound guided thrombin injection (UGTI)) and surgery to treat iatrogenic femoral artery pseudoaneurysms.

Methods: PubMed and Embase databases were searched up to October 2021. Primary outcome measure was success rate, and other outcomes examined were complication rate, reintervention rate. Two authors independently reviewed and extracted data. Data were presented as the odds ratios (ORs) with 95% confidence intervals (CIs). The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to appraise the quality of the body of evidence.

Results: Eight studies were included. A total of 623 patients with pseudoaneurysm undergoing treatment were included, of which 163 subjects underwent surgery, 397 subjects underwent compression, and 63 subjects underwent UGTI. The success rate was significantly lower in the non-surgery group (OR 0.24, 95% CI, 0.08-0.69, I 2 = 0%). The complication rate was significantly lower in the non-surgery group (OR 0.10, 95% CI, 0.03 -0.29, I 2 = 0%). Patients in the non-surgery group tended to have a lower, but statistically insignificant, reintervention rate (OR 0.11, 95% CI, 0.01-1.06, I 2 = 35%). Further, the GRADE assessment showed that these results (success rate, complication rate, and reintervention rate) were of very low quality.

Conclusions: Available evidence shows that it is reasonable to regard non-surgical treatment as the primary treatment for iatrogenic femoral artery pseudoaneurysms, and surgery as a remedy after failure of non-surgical treatment in some cases.

Keywords: UGTI; iatrogenic femoral artery pseudoaneurysm; surgery; ultrasound guided compression; ultrasound guided thrombin injection.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Literature search flow-chart.
Figure 2
Figure 2
Forest plot showing the pooled odds ratio for pseudoaneurysm treatment success rate after surgery and non-surgical treatment.
Figure 3
Figure 3
Forest plot showing the pooled odds ratio for pseudoaneurysm treatment complication rate after surgery and non-surgical treatment. CI, confidence interval; IV, inverse variance.
Figure 4
Figure 4
Forest plot showing the pooled odds ratio for pseudoaneurysm treatment reintervention rate after surgery and non-surgical treatment. CI, confidence interval; IV, inverse variance.
Figure 5
Figure 5
Forest plot showing the pooled odds ratio for failure rate of subgroup analysis about compression and UGTI group.
See this image and copyright information in PMC

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References

    1. Thom T, Haase N, Rosamond W, Howard VJ, Rumsfeld J, Manolio T, et al. Heart disease and stroke statistics–2006 update: a report from the American heart association statistics committee and stroke statistics subcommittee. Circulation. (2006) 113(6):e85–e151. 10.1161/circulationaha.105.171600 - DOI - PubMed
    1. Sachs T, Schermerhorn M, Pomposelli F, Cotterill P, O'Malley J, Landon B. Resident and fellow experiences after the introduction of endovascular aneurysm repair for abdominal aortic aneurysm. J Vasc Surg. (2011) 54(3):881–8. 10.1016/j.jvs.2011.03.008 - DOI - PMC - PubMed
    1. DeRubertis BG, Faries PL, McKinsey JF, Chaer RA, Pierce M, Karwowski J, et al. Shifting paradigms in the treatment of lower extremity vascular disease: a report of 1000 percutaneous interventions. Ann Surg. (2007) 246(3):415–22; discussion 22–4. 10.1097/SLA.0b013e31814699a2 - DOI - PMC - PubMed
    1. Kronzon I. Diagnosis and treatment of iatrogenic femoral artery pseudoaneurysm: a review. J Am Soc Echocardiogr. (1997) 10(3):236–45. 10.1016/s0894-7317(97)70061-0 - DOI - PubMed
    1. Kresowik TF, Khoury MD, Miller BV, Winniford MD, Shamma AR, Sharp WJ, et al. A prospective study of the incidence and natural history of femoral vascular complications after percutaneous transluminal coronary angioplasty. J Vasc Surg. (1991) 13(2):328–33; discussion 33–5. PMID: - PubMed

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