Details

Autor(en) / Beteiligte

• Hoke, Matthias, MD
• Koppensteiner, Renate, MD
• Schillinger, Martin, MD
• Haumer, Markus, MD
• Minar, Erich, MD
• Wiesbauer, Franz, MD
• Huber, Christian D., MA
• Mlekusch, Wolfgang, MD

Titel

D-dimer testing in the diagnosis of transfemoral pseudoaneurysm after percutaneous transluminal procedures

Ist Teil von

• Journal of vascular surgery, 2010-08, Vol.52 (2), p.383-387

Ort / Verlag

United States: Mosby, Inc

Erscheinungsjahr

2010

Quelle

Free E-Journal (出版社公開部分のみ）

Beschreibungen/Notizen

• Objective Pseudoaneurysms are characterized by extravascular circulation and therefore may lead to an activation of the coagulation cascade. We investigated d-dimer levels in patients with and without postcatheterization femoral pseudoaneurysms and hypothesized that d-dimer levels correlate with the presence of pseudoaneurysms at the vascular access site. Methods Patients with clinical suspected groin pseudoaneurysms after transluminal procedures were eligible. We compared prospectively-collected laboratory values of quantitative d-dimer testing in patients with and without pseudoaneurysms as assessed by color-coded duplex sonography. Furthermore, we measured the peak systolic velocity at the arterial fistula of each pseudoaneurysm. Results In 48 (40%) of 120 consecutive patients, a pseudoaneurysm was found. The level of d-dimer values was significantly higher in patients with postcatheterization femoral pseudoaneurysms compared with controls (1.9 μg/mL [interquartile range (IQR), 1.34-2.78 μg/mL] vs 0.8 μg/mL [IQR, 0.53-1.14 μg/mL]; P < .001). Values of d-dimer below 0.67 μg/mL have been calculated with a sensitivity of 94% (87%-100%), a specificity of 38% (27%-50%), a positive predictive value of 50% (40%-60%), a negative predictive value of 90% (82%-99%), and a likelihood ratio of 1.52 (1.25-1.85) with regard to the presence of pseudoaneurysms. We also found a significant correlation of the peak systolic velocity at the arterial fistula and increasing d-dimer levels (r = 0.98, P < .0001). Conclusion We found a significantly higher level of d-dimer values in patients with femoral pseudoaneurysms at the vascular access site. Therefore, d-dimer levels could be a potential serological marker in the diagnosis of pseudoaneurysms. A confirmation is warranted in a larger patient sample.