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Clinical and research medicine: Interventional cardiology
e0470 Ultrasound guided thrombin injection for the treatment of iatrogenic postcatheterisation pseudoaneurysms in 76 cases
  1. Guo Jincheng1,
  2. Ma Changsheng2,
  3. Xu Min1,
  4. Wang Guozhong1,
  5. Zhang Zhenghai1,
  6. Zhang Linxin1
  1. 1Luhe Hospital
  2. 2An Zhen Hospital

Abstract

Ultrasound-Guided Thrombin Injection For The Treatment Of Iatrogenic Post-Catheterisation Pseudoaneurysms In 76 Cases Objective The purpose of this study was to evaluate the safety and efficacy of ultrasound-guided thrombin injection (UGTI) for the treatment of iatrogenic post-catheterisation pseudoaneurysms (PSAs).

Methods A total of 76 patients (36 men, 40 women, 63.4±10.8 years) with iatrogenic PSAs were treated by UGTI.

Results The mean diameter of the aneurysms was (3.01±1.27)×(1.65±0.67) cm, 93.4% (71/76) of the patients were under antiplatelet therapy with aspirin or clopidogrel or both, and additional low molecular weight heparin. The mean dose of bovine thrombin was 619±259 (150∼1400) u, single injection was primary successful in 69 patients, of which thrombus formation occurred in 1 patient in the superficial femoral artery after successful closure of the PSA, surgical embolectomy was performed. A second injection was required in 2 of the remaining 7 patients. 5 patients were treated by ultrasound-guided compression because of incomplete thrombosis after UGTI. 1 patient had acute allergy after 2 min of thrombin injection which was resolved by antiallergic therapy. The total success rate was 98.7%(75/76). reperfusion was detected in 4 patients within 72 h follow-up, recurrence rate of UGTI for PSAs was 5.3% (4/75), 3 patients were successfully managed by a second thrombin injection and another was treated with ultrasuound-guidance compression, there is no recurrence at 30days clinical follow up. ultrasound follow-up. At the 2 months were performed in 15 patients. The size of PSAs were significantly reduced from (2.90±1.17), (1.47±0.54) cm to (0.94±0.72)´(0.44±0.35) cm (p<0.001).

Conclusion UGTI is a safe, rapid, well-tolerated and effective noninvasive method for the treatment of iatrogenic PSAs and should be considered as first-line therapy.

  • Aneurysm femoral artery thrombin

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