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