{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T23:49:40Z","timestamp":1783468180211,"version":"3.55.0"},"reference-count":47,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2021,8,24]],"date-time":"2021-08-24T00:00:00Z","timestamp":1629763200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Purpose<\/jats:title>\n<jats:p>To evaluate factors associated with pseudoaneurysm (PSA) development.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Between January 2016 and May 2020, 30,196 patients had invasive vascular radiological or cardiac endovascular procedures that required arterial puncture. All patients with PSA were identified. A matched (age, gender, and type of the procedure) control group of 134 patients was created to reveal predictors of PSA formation.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Single PSAs were found in 134 patients. Fifty-three PSAs developed after radiological procedures (53\/6555 [0.8%]), 31 after coronary artery procedures (31\/18038 [0.2%]), 25 after non-coronary artery cardiac procedures (25\/5603 [0.4%]), and 25 due to procedures in which the arterial puncture was unintended. Thirty-four PSAs (25.4%) were localized to the upper extremity arteries (vascular closure device [VCD], N = 0), while 100 (74.6%) arose from the lower extremity arteries (VCD, N = 37). The PSA prevalence was 0.05% (10\/20478) in the radial artery, 0.1% (2\/1818) in the ulnar artery, 1.2% (22\/1897) in the brachial artery, and 0.4% (99\/22202) in the femoral artery. Treatments for upper and lower limb PSAs were as follows: bandage replacement (32.4% and 14%, respectively), ultrasound-guided compression (11.8% and 1%, respectively), ultrasound-guided thrombin injection (38.2% and 78%, respectively), and open surgery (17.6% and 12%, respectively). Reintervention was necessary in 19 patients (14.2%). The prevalence of PSA for the punctured artery with and without VCD use was 37\/3555 (1%) and 97\/27204 (0.4%), respectively (OR, 2.94; 95% CI, 1.95\u20134.34; P&lt;0.001). The effect of red blood cell (RBC) count (P&lt;0.001), hematocrit value (P&lt;0.001), hemoglobin value (P&lt;0.001), international normalized ratio (INR; P&lt;0.001), RBC count\u2014INR interaction (P = 0.003), and RBC count\u2014VCD use interaction (P = 0.036) on PSA formation was significant.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Patients in whom the puncture site is closed with a VCD require increased observation. Preprocedural laboratory findings are useful for the identification of patients at high risk of PSA formation.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0256317","type":"journal-article","created":{"date-parts":[[2021,8,24]],"date-time":"2021-08-24T18:09:25Z","timestamp":1629828565000},"page":"e0256317","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":25,"title":["Incidence of and predisposing factors for pseudoaneurysm formation in a high-volume cardiovascular center"],"prefix":"10.1371","volume":"16","author":[{"given":"Hunor","family":"Sarkadi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judit","family":"Cs\u0151re","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9687-3556","authenticated-orcid":true,"given":"D\u00e1niel S\u00e1ndor","family":"Veres","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5670-745X","authenticated-orcid":true,"given":"N\u00e1ndor","family":"Szegedi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Levente","family":"Moln\u00e1r","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L\u00e1szl\u00f3","family":"Gell\u00e9r","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viktor","family":"B\u00e9rczi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2984-2642","authenticated-orcid":true,"given":"Edit","family":"D\u00f3sa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,8,24]]},"reference":[{"issue":"7\u20138","key":"pone.0256317.ref001","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1016\/j.diii.2015.06.009","article-title":"Post-procedure bleeding in interventional radiology.","volume":"96","author":"J Mayer","year":"2015","journal-title":"Diagn Interv Imaging"},{"issue":"3","key":"pone.0256317.ref002","doi-asserted-by":"crossref","first-page":"913","DOI":"10.1016\/j.jvs.2018.06.196","article-title":"Contrast-induced nephropathy after peripheral vascular intervention: Long-term renal outcome and risk factors for progressive renal dysfunction","volume":"69","author":"Z Al Adas","year":"2019","journal-title":"J Vasc Surg"},{"issue":"4","key":"pone.0256317.ref003","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1016\/j.ejvs.2019.05.011","article-title":"Incidence and Predictors of Neurological Complications Following Thoracic Endovascular Aneurysm Repair in the Global Registry for Endovascular Aortic Treatment","volume":"58","author":"M Piazza","year":"2019","journal-title":"Eur J Vasc Endovasc Surg"},{"issue":"1098","key":"pone.0256317.ref004","doi-asserted-by":"crossref","first-page":"20180893","DOI":"10.1259\/bjr.20180893","article-title":"Factors associated with pseudoaneurysm development and necessity for reintervention: a single centre study","volume":"92","author":"J Delf","year":"2019","journal-title":"Br J Radiol"},{"issue":"1","key":"pone.0256317.ref005","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1186\/s42155-020-00120-7","article-title":"Percutaneous treatment of vascular access-site complications: a ten years\u2019 experience in two centres.","volume":"3","author":"R Minici","year":"2020","journal-title":"CVIR Endovasc"},{"issue":"6","key":"pone.0256317.ref006","doi-asserted-by":"crossref","first-page":"305","DOI":"10.4174\/astr.2019.96.6.305","article-title":"Access site pseudoaneurysms after endovascular intervention for peripheral arterial diseases","volume":"96","author":"A Eleshra","year":"2019","journal-title":"Ann Surg Treat Res"},{"issue":"20","key":"pone.0256317.ref007","doi-asserted-by":"crossref","first-page":"2666","DOI":"10.1161\/CIRCULATIONAHA.106.681973","article-title":"Contemporary management of postcatheterization pseudoaneurysms","volume":"115","author":"GW Webber","year":"2007","journal-title":"Circulation"},{"issue":"5","key":"pone.0256317.ref008","doi-asserted-by":"crossref","first-page":"1030","DOI":"10.1536\/ihj.18-551","article-title":"Comparison of Postcatheterization Pseudoaneurysm between Brachial Access and Femoral Access","volume":"60","author":"Y Tamanaha","year":"2019","journal-title":"Int Heart J"},{"issue":"5","key":"pone.0256317.ref009","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1016\/j.ihj.2017.02.003","article-title":"Meta-analysis comparing radial versus femoral approach in patients 75 years and older undergoing percutaneous coronary procedures","volume":"69","author":"D Basu","year":"2017","journal-title":"Indian Heart J"},{"issue":"1","key":"pone.0256317.ref010","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1007\/s12928-016-0439-4","article-title":"Comparison of radial, brachial, and femoral accesses using hemostatic devices for percutaneous coronary intervention.","volume":"33","author":"M Otsuka","year":"2018","journal-title":"Cardiovasc Interv Ther"},{"issue":"73","key":"pone.0256317.ref011","doi-asserted-by":"crossref","first-page":"85","DOI":"10.15557\/JoU.2018.0012","article-title":"Ultrasound-guided thrombin injection in the management of pseudoaneurysm after percutaneous arterial access.","volume":"18","author":"T Jargie\u0142\u0142o","year":"2018","journal-title":"J Ultrason"},{"issue":"2","key":"pone.0256317.ref012","doi-asserted-by":"crossref","first-page":"164","DOI":"10.14366\/usg.17047","article-title":"Ultrasonographic evaluation of complications related to transfemoral arterial procedures.","volume":"37","author":"EJ Chun","year":"2018","journal-title":"Ultrasonography."},{"issue":"6","key":"pone.0256317.ref013","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1177\/1538574417708727","article-title":"Ultrasound-Guided Thrombin Injection Is a Safe and Effective Treatment for Femoral Artery Pseudoaneurysm in the Morbidly Obese.","volume":"51","author":"T Yoo","year":"2017","journal-title":"Vasc Endovascular Surg"},{"issue":"6","key":"pone.0256317.ref014","doi-asserted-by":"crossref","first-page":"1277","DOI":"10.1253\/circj.CJ-14-1119","article-title":"Ultrasound-guided percutaneous thrombin injection for post-catheterization pseudoaneurysm.","volume":"79","author":"S Kuma","year":"2015","journal-title":"Circ J"},{"issue":"6","key":"pone.0256317.ref015","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1016\/j.ejvs.2016.02.012","article-title":"Ultrasound Guided Compression Versus Ultrasound Guided Thrombin Injection for the Treatment of Post-Catheterization Femoral Pseudoaneurysms: Systematic Review and Meta-Analysis of Comparative Studies","volume":"51","author":"N Kontopodis","year":"2016","journal-title":"Eur J Vasc Endovasc Surg"},{"issue":"6","key":"pone.0256317.ref016","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1097\/01.JAA.0000558236.60240.02","article-title":"Management trends for postcatheterization femoral artery pseudoaneurysms","volume":"32","author":"C. Madia","year":"2019","journal-title":"JAAPA"},{"issue":"Suppl 1","key":"pone.0256317.ref017","doi-asserted-by":"crossref","first-page":"S173","DOI":"10.1148\/rg.25si055503","article-title":"Pseudoaneurysms and the role of minimally invasive techniques in their management.","volume":"25","author":"NE Saad","year":"2005","journal-title":"Radiographics"},{"issue":"3","key":"pone.0256317.ref018","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1148\/radiology.178.3.1994400","article-title":"Postangiographic femoral artery injuries: nonsurgical repair with US-guided compression","volume":"178","author":"BD Fellmeth","year":"1991","journal-title":"Radiology"},{"issue":"2","key":"pone.0256317.ref019","doi-asserted-by":"crossref","first-page":"383","DOI":"10.2214\/ajr.147.2.383","article-title":"Coagulation of aneurysms by direct percutaneous thrombin injection.","volume":"147","author":"C Cope","year":"1986","journal-title":"AJR Am J Roentgenol"},{"issue":"7","key":"pone.0256317.ref020","doi-asserted-by":"crossref","first-page":"1273","DOI":"10.1002\/ccd.27479","article-title":"Safety and efficacy of ulnar artery approach for percutaneous cardiac catheterization: Systematic review and meta-analysis","volume":"91","author":"R Fernandez","year":"2018","journal-title":"Catheter Cardiovasc Interv"},{"key":"pone.0256317.ref021","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1016\/j.ijcard.2016.07.294","article-title":"Ulnar pseudoaneurysm after transulnar coronary angiogram treated with percutaneous ultrasound-guided thrombin injection.","volume":"222","author":"K Polytarchou","year":"2016","journal-title":"Int J Cardiol"},{"issue":"3","key":"pone.0256317.ref022","doi-asserted-by":"crossref","DOI":"10.4081\/monaldi.2019.1109","article-title":"Radial pseudoaneurysm in elderly: a rare event with undefinied therapeutical approach. A case report and literature review.","volume":"89","author":"E Gallinoro","year":"2019","journal-title":"Monaldi Arch Chest Dis."},{"issue":"4","key":"pone.0256317.ref023","doi-asserted-by":"crossref","first-page":"295.e1","DOI":"10.1016\/j.jhsa.2017.01.024","article-title":"Radial Artery Pseudoaneurysm.","volume":"42","author":"R Tosti","year":"2017","journal-title":"J Hand Surg Am"},{"issue":"17","key":"pone.0256317.ref024","doi-asserted-by":"crossref","first-page":"e15309","DOI":"10.1097\/MD.0000000000015309","article-title":"Femoral artery pseudoaneurysm after carotid artery stenting: Two case reports","volume":"98","author":"SH Jeon","year":"2019","journal-title":"Medicine (Baltimore)."},{"issue":"2","key":"pone.0256317.ref025","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1148\/radiology.138.2.7455105","article-title":"Complications of angiography.","volume":"138","author":"SJ Hessel","year":"1981","journal-title":"Radiology"},{"issue":"6","key":"pone.0256317.ref026","doi-asserted-by":"crossref","first-page":"1082","DOI":"10.1161\/CIRCEP.113.000768","article-title":"Complications of catheter ablation of atrial fibrillation: a systematic review.","volume":"6","author":"A Gupta","year":"2013","journal-title":"Circ Arrhythm Electrophysiol"},{"issue":"1","key":"pone.0256317.ref027","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1161\/CIRCEP.109.859116","article-title":"Updated worldwide survey on the methods, efficacy, and safety of catheter ablation for human atrial fibrillation.","volume":"3","author":"R Cappato","year":"2010","journal-title":"Circ Arrhythm Electrophysiol"},{"issue":"8","key":"pone.0256317.ref028","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1016\/j.jcin.2011.03.019","article-title":"Transfemoral aortic valve implantation new criteria to predict vascular complications.","volume":"4","author":"K Hayashida","year":"2011","journal-title":"JACC Cardiovasc Interv"},{"issue":"8","key":"pone.0256317.ref029","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1016\/j.jcin.2013.05.004","article-title":"Management of vascular access in transcatheter aortic valve replacement: part 2: Vascular complications.","volume":"6","author":"S Toggweiler","year":"2013","journal-title":"JACC Cardiovasc Interv"},{"issue":"3","key":"pone.0256317.ref030","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1016\/j.jvs.2018.05.019","article-title":"A systematic review of vascular closure devices for femoral artery puncture sites","volume":"68","author":"VJ Noori","year":"2018","journal-title":"J Vasc Surg"},{"issue":"3","key":"pone.0256317.ref031","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1001\/jama.291.3.350","article-title":"Arterial puncture closing devices compared with standard manual compression after cardiac catheterization: systematic review and meta-analysis","volume":"291","author":"M Koreny","year":"2004","journal-title":"JAMA"},{"issue":"2","key":"pone.0256317.ref032","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/j.amjcard.2012.02.065","article-title":"Practices and complications of vascular closure devices and manual compression in patients undergoing elective transfemoral coronary procedures.","volume":"110","author":"NR Smilowitz","year":"2012","journal-title":"Am J Cardiol"},{"issue":"2","key":"pone.0256317.ref033","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1161\/CIRCINTERVENTIONS.113.000836","article-title":"Safety and efficacy of a potential treatment algorithm by using manual compression repair and ultrasound-guided thrombin injection for the management of iatrogenic femoral artery pseudoaneurysm in a large patient cohort","volume":"7","author":"M Dzijan-Horn","year":"2014","journal-title":"Circ Cardiovasc Interv"},{"issue":"2","key":"pone.0256317.ref034","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1136\/hrt.2004.053793","article-title":"Randomised comparison of manual compression repair versus ultrasound guided compression repair of postcatheterisation femoral pseudoaneurysms","volume":"92","author":"M Paschalidis","year":"2006","journal-title":"Heart"},{"issue":"5","key":"pone.0256317.ref035","doi-asserted-by":"crossref","first-page":"756","DOI":"10.1002\/ccd.26991","article-title":"A multicenter randomized trial comparing the effectiveness and safety of a novel vascular closure device to manual compression in anticoagulated patients undergoing percutaneous transfemoral procedures: The CELT ACD trial.","volume":"90","author":"SC Wong","year":"2017","journal-title":"Catheter Cardiovasc Interv."},{"issue":"2","key":"pone.0256317.ref036","first-page":"75","article-title":"The value of different forms of compression therapy in the treatment of iatrogenic femoral pseudoaneurysms.","volume":"13","author":"K Pawlaczyk","year":"2007","journal-title":"Acta Angiol"},{"issue":"4","key":"pone.0256317.ref037","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1055\/s-0034-1382100","article-title":"Novel Technique to Treat Common Femoral Artery Pseudoaneurysm using Angio-Seal Closure Device","volume":"25","author":"J Robken","year":"2016","journal-title":"Int J Angiol"},{"issue":"3","key":"pone.0256317.ref038","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1024\/0301-1526\/a000691","article-title":"Do not underestimate the femoral pseudoaneurysm","volume":"47","author":"M Stolt","year":"2018","journal-title":"Vasa"},{"issue":"8","key":"pone.0256317.ref039","doi-asserted-by":"crossref","first-page":"1196","DOI":"10.1016\/j.amjcard.2007.11.072","article-title":"Anemia as an independent predictor of perioperative and long-term cardiovascular outcome in patients scheduled for elective vascular surgery","volume":"101","author":"M Dunkelgrun","year":"2008","journal-title":"Am J Cardiol"},{"issue":"6","key":"pone.0256317.ref040","doi-asserted-by":"crossref","first-page":"1096","DOI":"10.1097\/SLA.0b013e318288e957","article-title":"Preoperative anemia is an independent predictor of postoperative mortality and adverse cardiac events in elderly patients undergoing elective vascular operations","volume":"258","author":"PK Gupta","year":"2013","journal-title":"Ann Surg"},{"issue":"6","key":"pone.0256317.ref041","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1161\/CIRCINTERVENTIONS.113.000409","article-title":"Prevalence, factors associated with, and prognostic effects of preoperative anemia on short- and long-term mortality in patients undergoing transcatheter aortic valve implantation.","volume":"6","author":"RJ Nuis","year":"2013","journal-title":"Circ Cardiovasc Interv"},{"issue":"1","key":"pone.0256317.ref042","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1111\/voxs.12331","article-title":"Role of red blood cells in haemostasis and thrombosis","volume":"12","author":"RI Litvinov","year":"2017","journal-title":"ISBT Sci Ser"},{"issue":"7","key":"pone.0256317.ref043","doi-asserted-by":"crossref","first-page":"1536","DOI":"10.1111\/j.1537-2995.2010.02586.x","article-title":"Effects of red blood cells on hemostasis","volume":"50","author":"WW Roeloffzen","year":"2010","journal-title":"Transfusion"},{"issue":"4","key":"pone.0256317.ref044","doi-asserted-by":"crossref","first-page":"1584","DOI":"10.1016\/S0006-3495(95)80031-7","article-title":"Physical and chemical effects of red cells in the shear-induced aggregation of human platelets","volume":"69","author":"HL Goldsmith","year":"1995","journal-title":"Biophys J"},{"issue":"2","key":"pone.0256317.ref045","first-page":"165","article-title":"Percutaneous coronary intervention in patients with active bleeding or high bleeding risk.","volume":"13","author":"J Nguyen","year":"2013","journal-title":"Anadolu Kardiyol Derg"},{"issue":"1 Suppl","key":"pone.0256317.ref046","doi-asserted-by":"crossref","first-page":"321S","DOI":"10.1378\/chest.119.1_suppl.321S","article-title":"Antithrombotic therapy in patients undergoing percutaneous coronary intervention.","volume":"119","author":"JJ Popma","year":"2001","journal-title":"Chest."},{"issue":"7","key":"pone.0256317.ref047","doi-asserted-by":"crossref","first-page":"299","DOI":"10.14740\/jmc2543w","article-title":"Spontaneous Rupture of a Deep Femoral Pseudoaneurysm Mimicking Lymphedema After Radical Hysterectomy in a Woman Who Was Receiving Warfarin.","volume":"7","author":"S Ikedaa","year":"2016","journal-title":"J Med Cases."}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0256317","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,8,24]],"date-time":"2021-08-24T18:10:04Z","timestamp":1629828604000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0256317"}},"subtitle":[],"editor":[{"given":"Gabor","family":"Erdoes","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2021,8,24]]},"references-count":47,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2021,8,24]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0256317","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,24]]}}}