Treatment of iatrogenic femoral artery pseudoaneurysm with percutaneous thrombin injection
Resource
JOURNAL OF VASCULAR SURGERY 26(1),18-23
Journal
JOURNAL OF VASCULAR SURGERY 26
Pages
18-23
Date Issued
1996
Date
1996
Author(s)
DOI
246246/2006111501275512
Abstract
Purpose: Local compression has been advocated for the treatment of femoral artery
pseudoaneurysms. Although it is effective and has a high success rate, this method bears
some limitations; among them are prolonged procedure time, discomfort for patients,
and recurrence. As a potent thrombosis-inducing agent, thrombin has been used topi-
caUy, and occasionally intravascularly, for hemostasis. Pseudoaneurysms with a narrow
connecting tract to the native artery may be suitable for treatment with thrombin
injection to induce intracavitary coagulation.
Methods: Patients with pseudoaneurysms of the femoral artery were evaluated by ultra-
sonography. Under ultrasound guidance, an intravenous catheter was introduced percu-
taneously into the pseudoaneurysm, with the catheter position confirmed by contrast
ultrasonography. One thousand units of thrombin dissolved in normal saline solution
was then injected slowly into the pseudoaneurysm through the catheter to induce
thrombosis. The patients were monitored closely for any adverse effects after thrombin
injection.
Results: A total of five patients with femoral artery pseudoaneurysms were treated with
direct percutaneous thrombin injection under ultrasound guidance. Within seconds of
thrombin injection thrombus formation was evident, and blood flow in the pseudoaneu-
rysm soon ceased when the thrombosis extended to the connecting tract. All procedures
were uneventful and successful. No recurrence was noted during follow-up periods of 1
to 28 months.
Conclusion: Our initial experience with the small number of patients demonstrates the
simplicity, lack of morbidity, and high success rate for ultrasotmd-guided percutaneous
thrombin injection for the treatment of femoral artery pseudoaneurysms. (J Vase Surg
1997;26:18-23.)
Type
journal article
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