Percutaneous ultrasound-guided balloon-assisted embolization of iatrogenic femoral artery pseudoaneurysms with Glubran®2 cyanoacrylate glue: safety, efficacy and outcomes

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 (INCA-MS) Glubran (R) 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 mast cases, offering complete exclusion of the PA and avoiding the morbidity of open surgery.
Liste complète des métadonnées

https://hal-univ-bourgogne.archives-ouvertes.fr/hal-01936828
Contributeur : Le2i - Université de Bourgogne <>
Soumis le : mardi 27 novembre 2018 - 16:24:55
Dernière modification le : mardi 27 novembre 2018 - 16:24:57

Lien texte intégral

Identifiants

Collections

Citation

Loïc Griviau, Olivier Chevallier, Clément Marcelin, Motoki Nakai, Lorenzo Pescatori, et al.. Percutaneous ultrasound-guided balloon-assisted embolization of iatrogenic femoral artery pseudoaneurysms with Glubran®2 cyanoacrylate glue: safety, efficacy and outcomes. Quantitative Imaging in Medicine and Surgery, AME Publishing, 2018, 8 (8), pp.796 - 803. ⟨http://qims.amegroups.com/article/view/21352/21133⟩. ⟨10.21037/qims.2018.09.12⟩. ⟨hal-01936828⟩

Partager

Métriques

Consultations de la notice

27