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

Loïc Griviau 1 Olivier Chevallier 1 Clément Marcelin 2 Motoki Nakai 3 Lorenzo Pescatori 1 Christophe Galland 1 Marco Midulla 1 Nicolas Falvo 1 Romaric Loffroy 1, *
* Auteur correspondant
1 Service de radiologie et d'Imagerie médicale diagnostique et thérapeutique (CHU de Dijon)
2 Service de médecine nucléaire [Bordeaux]
3 Department of radiology
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.
Keywords : Pseudoaneurysm (PA) femoral artery embolization cyanoacrylate glue access site complication Thrombin Injection Compression Repair Pseudo-Aneurysms Complications Experience
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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

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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. ⟨10.21037/qims.2018.09.12⟩. ⟨hal-01936828⟩

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