US-guided percutaneous thrombin injection of postcatheterization pseudoaneurysms


Gürel K., Gür S., Özkan U., Tekbaş G., ÖNDER H., Oǧuzkurt L.

Diagnostic and Interventional Radiology, cilt.18, sa.3, ss.319-325, 2012 (SCI-Expanded, Scopus)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 18 Sayı: 3
  • Basım Tarihi: 2012
  • Doi Numarası: 10.4261/1305-3825.dir.4933-11.1
  • Dergi Adı: Diagnostic and Interventional Radiology
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.319-325
  • Anahtar Kelimeler: pseudoaneurysm, therapeutic embolization, thrombin
  • Sağlık Bilimleri Üniversitesi Adresli: Evet

Özet

PURPOSE This study retrospectively evaluated ultrasonography-guided (US-guided) percutaneous thrombin injection for the treatment of postcatheterization femoral and brachial artery pseudoaneurysms. MATERIALS AND METHODS Fifty-five patients with postcatheterization femoral artery (n=53) or brachial artery (n=2) pseudoaneurysms were treated using US-guided human thrombin (500 IU/mL) injection. Pseudoaneurysm size, thrombin dose, therapy outcome, and complications were documented. Follow-up color Doppler US was performed 7 and 30 days after treatment. Short-duration supplemental compression was applied to six patients at the first week follow-up examination after a reinjection of thrombin had failed. RESULTS Mean pseudoaneurysm volume was 20.3±18.7 cm 3. The mean injected thrombin dose was 478±238 IU. Thirty-eight (69.1%) of the 55 pseudoaneurysms were thrombosed with a single injection, and 11 of 17 pseudoaneurysms were thrombosed after a second injection. All (100%) of the 41 pseudoaneurysms that were diagnosed within the first two weeks of postcatheterization were successfully treated. The overall primary success rate was 89.1% (49 of 55 pseudoaneurysms). Supplemental compression promoted thrombosis in four of the six patients who had treatment failure with thrombin injection. The secondary success rate was 96.4% (53 of 55 pseudoaneurysms). There were no complications. CONCLUSION US-guided thrombin injection was most successful within the first two weeks, and the supplemental compression might aid in the closure of partially thrombosed pseudoaneurysms. © Turkish Society of Radiology 2012.