The Role of Anticoagulants and Platelet Aggregation Inhibitors in the Treatment of Pseudoaneurysms and Risk of Venous Thrombosis

Angiology. 2024 Feb;75(2):156-165. doi: 10.1177/00033197221143321. Epub 2022 Dec 5.

Abstract

Pseudoaneurysms (PSA) are one of the most common complications after arterial punctures. This retrospective study examined whether platelet aggregation inhibitors (APT) or anticoagulants (AC) lower the success rates of PSA treatment. A total of 468 patients with PSA were retrospectively analyzed between 2010 and 2018, and 238 were included in the study. Despite co-medication with APT or AC, thrombin injection (TI) was superior to compression bandage (CB) therapy in treating PSA (TIwAC 79 vs CBwAC 51%; P = .004 and TIwAPT 93 vs CBwAPT 54%; P = .001). There was no decrease in PSA-associated thrombosis in patients requiring anticoagulation after TI. The success rates of the TI and CB groups were compared in patients with and without AC therapy, and the latter was significantly lower. A reduced success rate was not observed in CB therapy patients requiring APT. In contrast, better results were seen in the TI group. Regarding PSA treatment, TI therapy is significantly superior to CB, including in patients requiring concomitant AC or APT therapy. PSA-associated thrombosis also occurs in patients requiring anticoagulation, and sonography should be performed. Concomitant medication use with APT does not significantly influence PSA therapy success or prevention of PSA-associated thrombosis.

Keywords: bleeding; complication; compression bandage; pseudoaneurysm; thrombin injection; ultrasonography; venous thrombosis.

MeSH terms

  • Aneurysm, False* / diagnostic imaging
  • Aneurysm, False* / drug therapy
  • Aneurysm, False* / etiology
  • Anticoagulants / adverse effects
  • Femoral Artery
  • Humans
  • Platelet Aggregation Inhibitors / adverse effects
  • Retrospective Studies
  • Thrombin
  • Thrombosis* / complications
  • Venous Thrombosis* / complications

Substances

  • Platelet Aggregation Inhibitors
  • Anticoagulants
  • Thrombin