Percutaneous Treatment of Iatrogenic Femoral Artery Access Complications

Dimitrios K Tsetis, Evangelos Perdikakis, Elias Kehagias

Abstract


Percutaneous minimal invasive treatment of iatrogenic femoral artery access complications (IFAACs) is considered as a first choice treatment in selected cases. Percutaneous procedures are performed under local anaesthesia, are better tolerated by the patient, and are associated with a shorter hospitalisation time, compared to open surgery. Bleeding complications can be insidious and life-threatening and prompt sealing of arterial leakage with stent-grafts or embolisation are life-saving procedures. Percutaneous US-guided thrombin injection is the treatment of choice for femoral pseudoaneurysms. The vast majority of arteriovenous fistulas (AVFs) can be treated effectively with stent-graft implantation even if the AVF is located very close to the femoral bifurcation. Catheter-directed thrombolysis assisted by subsequent prolonged balloon inflation or stent placement is able to treat effectively acute arterial thrombosis. Occasionally stenoses or occlusions provoked by percutaneous closure devices can also be managed by endovascular means.


Keywords


femoral catheterisation; iatrogenic; pseudoaneurysm; dissection; arteriovenous fistula; stent graft

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