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

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

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)383-387
Number of pages5
JournalJournal of Vascular Surgery
Volume52
Issue number2
DOIs
StatePublished - Aug 2010

All Science Journal Classification (ASJC) codes

  • Surgery
  • Cardiology and Cardiovascular Medicine

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