In 1200 cases of angiographic or invasive procedures with puncture of the femoral artery, vascular complications occurred in 10 patients (0.8%). In a prospective study, duplex sonography and intravenous digital subtraction angiography were used as diagnostic methods in these cases. All 10 cases with vascular complications were diagnosed correctly by means of i.v. DSA, and the underlying pathology was documented exactly. Duplex sonography yielded the correct diagnosis in 8 cases, and 1 case was incorrectly diagnosed as an aneurysm; angiography suggested an arteriovenous fistula, which was surgically verified. In one case duplex sonography was negative. The noninvasive procedure of duplex sonography plays an important role in the diagnosis of post-puncture vascular complications. Because of its high accuracy, this simple method should be the first diagnostic step. Intravenous DSA should be used in cases where the results obtained with duplex sonography are equivocal.
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