@article{QIMS21352,
author = {Loïc Griviau and Olivier Chevallier and Clément Marcelin and Motoki Nakai and Lorenzo Pescatori and Christophe Galland and Marco Midulla and Nicolas Falvo and Romaric Loffroy},
title = {Percutaneous ultrasound-guided balloon-assisted embolization of iatrogenic femoral artery pseudoaneurysms with Glubran®2 cyanoacrylate glue: safety, efficacy and outcomes},
journal = {Quantitative Imaging in Medicine and Surgery},
volume = {8},
number = {8},
year = {2018},
keywords = {},
abstract = {Background: Femoral pseudoaneurysm (PA) is a frequent complication of arterial access for endovascular procedures. Surgery has traditionally been considered as the gold standard of therapy. We aimed to report our experience of percutaneous ultrasound (US)-guided balloon-assisted embolization with cyanoacrylate glue for the treatment of iatrogenic femoral PAs.
Methods: Retrospective two-center study of patients with femoral iatrogenic PAs treated by N-butyl cyanoacrylate-methacryloxy sulfolane (NBCA-MS) Glubran®2 glue embolization between July 2013 and November 2017. All patients underwent contralateral arterial access with balloon placement of an appropriate size in front of the PA neck before glue/lipiodol embolization in a 1:1 ratio by percutaneous US-guided puncture of the aneurysmal sac under fluoroscopy control.
Results: Twenty-three patients (12 females, 11 males; median age, 79 years; range, 18–93 years) were included. Median PA size was 34 mm (range, 17–60 mm). The median time to treatment was 5 days (range, 1–30 days). Twenty patients (86.9%) were successfully treated by glue injection alone. The three remaining patients (13.1%) with persistent PA or associated arterial-venous fistula were immediately treated during the same procedure by additional stent-graft. Then, overall immediate and 1-month clinical success rates were 100%. No surgical conversion was necessary. No recurrence was reported during the median follow-up of 11 months (range, 2–73 months). Two (8.7%) puncture-related complications occurred at the contralateral arterial access site, which spontaneously resolved. No non-target glue embolization occurred.
Conclusions: US-guided balloon-assisted glue embolization is safe and effective to treat iatrogenic femoral PAs in most cases, offering complete exclusion of the PA and avoiding the morbidity of open surgery.},
issn = {2223-4306}, url = {https://qims.amegroups.org/article/view/21352}
}