Femoral pseudoaneurysm in patients undergoing primary percutaneous coronary intervention for ST-elevation myocardial infarction

Abstract

Purpose: Various peripheral vascular complications may be observed after cardiac catheterization. However, no data are available about femoral pseudoaneurysm (FPA) after urgent primary percutaneous coronary intervention (PCI). We sought to determine the in-hospital incidence, clinical course and predictors of FPA in patients with ST elevation myocardial infarction (STEMI) undergoing primary PCI. Methods: 2,600 consecutive STEMI patients (mean age: 56.5±11.7 years; 2158 men) undergoing primary PCI were retrospectively enrolled into this study. Patients were evaluated with Doppler Ultrasonography following PCI and categorized into two groups according to whether FPA developed or not. All the parameters were compared between FPA and non-FPA groups. Results: The incidence of FPA after primary PCI was determined to be 2.3%. The mean age was higher in the FPA group compared to the non-FPA group (mean age: 60.6±11.6 vs. 56.5±11.8, respectively, p=0.007). Furthermore, the FPA developing group experienced prolonged hospitalizations compared to the non-FPA group, but no differences in in-hospital or long term mortality were noticed. In the multivariate analysis of this study, female gender and age (>75 years), after primary PCI, were found to be independent predictors of FPA. Conclusions: High incidence of FPA was noticed in STEMI patients undergoing primary PCI, which prolonged in-hospital stay. Extra care must be given, especially to women and those who are >75 years of age, for this complication.