TY - JOUR
T1 - D-dimer testing in the diagnosis of transfemoral pseudoaneurysm after percutaneous transluminal procedures
AU - Hoke, Matthias
AU - Koppensteiner, Renate
AU - Schillinger, Martin
AU - Haumer, Markus
AU - Minar, Erich
AU - Wiesbauer, Franz
AU - Huber, Christian D.
AU - Mlekusch, Wolfgang
PY - 2010/8
Y1 - 2010/8
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=77955514901&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77955514901&partnerID=8YFLogxK
U2 - 10.1016/j.jvs.2010.02.275
DO - 10.1016/j.jvs.2010.02.275
M3 - Article
C2 - 20488641
AN - SCOPUS:77955514901
SN - 0741-5214
VL - 52
SP - 383
EP - 387
JO - Journal of Vascular Surgery
JF - Journal of Vascular Surgery
IS - 2
ER -