Femoral artery pseudoaneurysms: value of color Doppler sonography in predicting which ones will thrombose without treatment.

Abstract

The purpose of this study was to evaluate the Doppler imaging characteristics of femoral artery pseudoaneurysms occurring after cardiac catheterization to determine if color Doppler sonography can be used to predict which pseudoaneurysms would ultimately thrombose spontaneously. Over a 30-month-period, 24 pseudoaneurysms were studied with serial color Doppler sonography. The color flow, B-mode, and Doppler spectral images and clinical records of patients whose pseudoaneurysms demonstrated spontaneous thrombosis were compared with those of patients who required surgical repair of the pseudoaneurysm. We found no statistically significant differences between the patients whose pseudoaneurysms demonstrated spontaneous thrombosis and those treated surgically in regard to clinical parameters or the volume of the pseudoaneurysm, percentage of flow within the pseudoaneurysm, ratio of forward to reversed flow velocity in the pseudoaneurysm neck, duration of diastolic flow in the pseudoaneurysm neck, or length of pseudoaneurysm neck. However, on color Doppler images, the volume of flow in the lumens of pseudoaneurysms that thrombosed spontaneously (1.8 +/- 3.3 ml) was significantly smaller than the volume of flow in the lumens of those treated surgically (4.4 +/- 3.2, ml, p = .02). We conclude that pseudoaneurysms with small volumes of flow in the lumen are more likely to thrombose than are those with large volumes of flow in the lumen. However, color Doppler sonographic characteristics cannot be used to predict subsequent thrombosis.