METHOD FOR SELECTION OF TREATMENT TACTICS FOR PATIENTS WITH PROBABILITY OF IATROGENIC POST-PUNCTURE FALSE ANEURYSMS OF FEMORAL ARTERIES Russian patent published in 2018 - IPC A61B8/00 A61B17/00 

FIELD: medicine.

SUBSTANCE: every day after a puncture, hemodynamic parameters are determined at the patient's examination: blood pressure and heart rate, revealing the presence or absence of instability of these indicators - a decrease in blood pressure by 20% or more in comparison with the baseline level determined before the puncture, against the background of tachycardia, and without it. Also, the presence or absence of signs of possible bleeding is determined: skin pallor, general weakness, syncopal condition, reduction of pulse tension on the radial artery, reduction of the haemoglobin level by 20% or more in comparison with the baseline level determined before the puncture. When the stable hemodynamic parameters are combined with the absence of a false femoral artery aneurysm, according to ultrasound dopplerography with duplex scanning (USDG + DS) of the femoral artery and absence of signs of possible bleeding, a dynamic observation of the puncture zone is performed. When the stable hemodynamic parameters are combined with the presence of false femoral artery aneurysm, according to the results of USDG + DS and the absence of signs of possible bleeding, dynamic monitoring is performed with conservative treatment in the form of a pressure bandage applied to the projection of a false aneurysm within 3-6 days, anticoagulant rejection, while continuing taking clopidogrel, strict bed rest adherence. At that, dynamic observation includes USDG + DS of the femoral artery in the puncture projection every 3 days and, if after 6 days of conservative treatment the false aneurysm of the femoral artery is preserved, surgical suturing of this defect is performed. When the stable hemodynamics parameters are combined with the presence of a southern aneurysm of the femoral artery, according to the results of USDG + DS and the presence of at least one sign of possible bleeding, surgical suturing of this defect is performed. If there is at least one sign of possible bleeding and unstable hemodynamic parameters, the femoral artery defect is urgently surgically sutured.

EFFECT: method promotes earlier detection of post-puncture false femoral artery aneurysm, which allows timely appointment of treatment measures aimed at prevention of adverse outcomes associated with bleeding from the puncture hole in the femoral artery and avoid surgical intervention in some cases.

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