Incidence, clinical course, and risk factors in the development of femoral pseudoaneurysm after atrial fibrillation ablation
Abstract Background Previous studies have revealed the risk factors for femoral pseudoaneurysms (FPA). Most data on FPA are based on coronary and peripheral interventions, with limited studies focusing on atrial fibrillation (AF) ablation. However, patient backgrounds, anticoagulation regimens, and...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-12-01
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| Series: | Journal of Arrhythmia |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/joa3.12950 |
| _version_ | 1797429073340792832 |
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| author | Takafumi Koyama Kazuki Tobita Tatsuto Kawaguchi Shuhei Uchida Eiji Koyama Nobuhisa Kodera Yusuke Tamaki Yuri Otomaru Hirokazu Miyashita Takayoshi Yamashita Shingo Mizuno Masato Murakami Shigeru Saito |
| author_facet | Takafumi Koyama Kazuki Tobita Tatsuto Kawaguchi Shuhei Uchida Eiji Koyama Nobuhisa Kodera Yusuke Tamaki Yuri Otomaru Hirokazu Miyashita Takayoshi Yamashita Shingo Mizuno Masato Murakami Shigeru Saito |
| author_sort | Takafumi Koyama |
| collection | DOAJ |
| description | Abstract Background Previous studies have revealed the risk factors for femoral pseudoaneurysms (FPA). Most data on FPA are based on coronary and peripheral interventions, with limited studies focusing on atrial fibrillation (AF) ablation. However, patient backgrounds, anticoagulation regimens, and vascular access methods differ. In addition, a standard for managing FPA after AF ablation remains elusive due to the difficult nature of achieving thrombosis in pseudoaneurysms. Methods This single‐center, retrospective, observational study included 2805 consecutive patients who underwent AF ablation between January 2016 and December 2021. All patients underwent femoral artery and vein punctures. Puncture sites were checked 1 day post‐procedure. Results A total of 23 FPA patients were identified during the study period. Multivariate logistic regression analysis showed that hypertension (odds ratio 4.66, 95% confidence interval: 1.38–15.71; p = .0032) and warfarin use (odds ratio 3.83, 95% confidence interval: 1.40–10.45; p = .021) were significantly associated with the occurrence of FPA. The compression success rate was low (22%). There were nine and six patients in the endovascular treatment (EVT) and ultrasound‐guided thrombin injection (UGTI) groups, respectively. The success rates were 100% and 84% in the EVT and UGTI groups, respectively. The length of hospital stay after FPA treatment was 2.1 days in the EVT group and 1.3 days in the thrombin group. Conclusion We must be careful about post‐procedural FPA, especially for hypertension and warfarin‐using patients. Treatment of pseudoaneurysms with anticoagulants is unlikely to achieve hemostasis, and an early switch to invasive treatments, such as EVT, should be considered. |
| first_indexed | 2024-03-09T09:07:55Z |
| format | Article |
| id | doaj.art-3df2e6549e3a49638ba752cbcb93d9ae |
| institution | Directory Open Access Journal |
| issn | 1880-4276 1883-2148 |
| language | English |
| last_indexed | 2024-03-09T09:07:55Z |
| publishDate | 2023-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Arrhythmia |
| spelling | doaj.art-3df2e6549e3a49638ba752cbcb93d9ae2023-12-02T09:34:11ZengWileyJournal of Arrhythmia1880-42761883-21482023-12-0139689490010.1002/joa3.12950Incidence, clinical course, and risk factors in the development of femoral pseudoaneurysm after atrial fibrillation ablationTakafumi Koyama0Kazuki Tobita1Tatsuto Kawaguchi2Shuhei Uchida3Eiji Koyama4Nobuhisa Kodera5Yusuke Tamaki6Yuri Otomaru7Hirokazu Miyashita8Takayoshi Yamashita9Shingo Mizuno10Masato Murakami11Shigeru Saito12Department of Cardiology Shonan Kamakura General Hospital Kamakura JapanDepartment of Cardiology Shonan Kamakura General Hospital Kamakura JapanDepartment of Cardiology Shonan Kamakura General Hospital Kamakura JapanDepartment of Cardiology Shonan Kamakura General Hospital Kamakura JapanDepartment of Cardiology Shonan Kamakura General Hospital Kamakura JapanDepartment of Cardiology Shonan Kamakura General Hospital Kamakura JapanDepartment of Cardiology Shonan Kamakura General Hospital Kamakura JapanDepartment of Cardiology Shonan Kamakura General Hospital Kamakura JapanDepartment of Cardiology Shonan Kamakura General Hospital Kamakura JapanDepartment of Cardiology Shonan Kamakura General Hospital Kamakura JapanDepartment of Cardiology Shonan Kamakura General Hospital Kamakura JapanDepartment of Cardiology Shonan Kamakura General Hospital Kamakura JapanDepartment of Cardiology Shonan Kamakura General Hospital Kamakura JapanAbstract Background Previous studies have revealed the risk factors for femoral pseudoaneurysms (FPA). Most data on FPA are based on coronary and peripheral interventions, with limited studies focusing on atrial fibrillation (AF) ablation. However, patient backgrounds, anticoagulation regimens, and vascular access methods differ. In addition, a standard for managing FPA after AF ablation remains elusive due to the difficult nature of achieving thrombosis in pseudoaneurysms. Methods This single‐center, retrospective, observational study included 2805 consecutive patients who underwent AF ablation between January 2016 and December 2021. All patients underwent femoral artery and vein punctures. Puncture sites were checked 1 day post‐procedure. Results A total of 23 FPA patients were identified during the study period. Multivariate logistic regression analysis showed that hypertension (odds ratio 4.66, 95% confidence interval: 1.38–15.71; p = .0032) and warfarin use (odds ratio 3.83, 95% confidence interval: 1.40–10.45; p = .021) were significantly associated with the occurrence of FPA. The compression success rate was low (22%). There were nine and six patients in the endovascular treatment (EVT) and ultrasound‐guided thrombin injection (UGTI) groups, respectively. The success rates were 100% and 84% in the EVT and UGTI groups, respectively. The length of hospital stay after FPA treatment was 2.1 days in the EVT group and 1.3 days in the thrombin group. Conclusion We must be careful about post‐procedural FPA, especially for hypertension and warfarin‐using patients. Treatment of pseudoaneurysms with anticoagulants is unlikely to achieve hemostasis, and an early switch to invasive treatments, such as EVT, should be considered.https://doi.org/10.1002/joa3.12950aneurysm false*/etiologyatrial fibrillationcatheter ablation/adverse effects*thrombin* |
| spellingShingle | Takafumi Koyama Kazuki Tobita Tatsuto Kawaguchi Shuhei Uchida Eiji Koyama Nobuhisa Kodera Yusuke Tamaki Yuri Otomaru Hirokazu Miyashita Takayoshi Yamashita Shingo Mizuno Masato Murakami Shigeru Saito Incidence, clinical course, and risk factors in the development of femoral pseudoaneurysm after atrial fibrillation ablation Journal of Arrhythmia aneurysm false*/etiology atrial fibrillation catheter ablation/adverse effects* thrombin* |
| title | Incidence, clinical course, and risk factors in the development of femoral pseudoaneurysm after atrial fibrillation ablation |
| title_full | Incidence, clinical course, and risk factors in the development of femoral pseudoaneurysm after atrial fibrillation ablation |
| title_fullStr | Incidence, clinical course, and risk factors in the development of femoral pseudoaneurysm after atrial fibrillation ablation |
| title_full_unstemmed | Incidence, clinical course, and risk factors in the development of femoral pseudoaneurysm after atrial fibrillation ablation |
| title_short | Incidence, clinical course, and risk factors in the development of femoral pseudoaneurysm after atrial fibrillation ablation |
| title_sort | incidence clinical course and risk factors in the development of femoral pseudoaneurysm after atrial fibrillation ablation |
| topic | aneurysm false*/etiology atrial fibrillation catheter ablation/adverse effects* thrombin* |
| url | https://doi.org/10.1002/joa3.12950 |
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