Blood Indices and CHA2DS2VASC Score in Patients who Underwent Manual Compression Repair for Femoral Artery Pseudoaneurysms

INTRODUCTION: Manual compression repair (MCR) for femoral artery pseudoaneurysm (FAP) is an earlier and well-known nonsurgical procedure. Relationship with the success of MCR and CHA2DS2VASC score, neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), mean platelet volume (MPV), and red-cell distribution width (RDW) were unknown.
METHODS: We investigated 17,391 catheterization procedures from April 2009 to December 2015. 118 FAPs were suitable for MCR. Age, sex, concomitant vascular disease, and laboratory findings were compared between patients who have non-thrombosed pseudoaneurysm (NTP) and those who have thrombosed pseudoaneurysm (TP) after one or more MCR attempts.
RESULTS: 81 FAPs were successfully sealed after one or more MCR attempts. The success rate was 38.9% at the first attempt and 68.6% at the third attempt. The dual antiplatelet usage rate was high (68.5%) in the study population. FAP dimensions, fistula tract width, or length did not differ between groups. Patients who have sealed pseudoaneurysm have a higher CHA2DS2VASC score (2 [1–3.5] vs. 3 [2–4], p=0.019). There is no difference in terms of NLR, PLR, RDW, and MPV. Patients in TP group were found to have a thicker left ventricular posterior wall (PW) on transthoracic echocardiogram (1.0±0.2 vs. 1.1±0.2, p=0.047).
DISCUSSION AND CONCLUSION: MCR may be considered as a therapeutic option for FAPs. It is well-known, a practical procedure without the need for costly equipment. MCR treatment was successful at older ages, high CHA2DS2VASC score, and a thicker PW on transthoracic echocardiography. Multiple attempts should be used for clinical success.