[Ultrasound guided percutaneous thrombin injection for treatment of a pseudoaneurysm after inguinal or brachial catheterization; good results in 14 patients].

Abstract

OBJECTIVE:

Evaluation of percutaneous ultrasound guided thrombin injection for treatment of postcatheterization pseudoaneurysms.

DESIGN:

Prospective.

METHOD:

In the period 1 April 1999-30 June 2000, all patients with postcatheterization pseudoaneurysms were included and primarily treated with ultrasound guided percutaneous thrombin injection. Under ultrasound guidance a 22 gauge needle was percutaneously positioned within the pseudoaneurysm and a thrombin solution was slowly injected to induce thrombosis. Distal pulses and ankle-brachial indexes were measured before and after the procedure. Colour Doppler ultrasound examination was repeated after 1 day, 1 week and 6 weeks.

RESULTS:

Fourteen patients were included: 6 men and 8 women, age range 50-79 year (mean: 66 year). Thirteen of 14 pseudoaneurysms, 12 femoral and 2 brachial pseudoaneurysms, were successfully treated with thrombin injection. Twelve pseudoaneurysms thrombosed after 1 injection. Because of recurrence 2 patients needed a second injection. One patient developed a recurrence after 2 injections and was referred for surgical treatment. Doses of thrombin needed varied between 150-1000 units. The whole procedure took 15 minutes on average. One patient developed a superficial infection 2 weeks after treatment at the site of the thrombosed pseudoaneurysm which needed incision and drainage in the outpatient department. No thromboembolic complications were found.

CONCLUSION:

Percutaneous thrombin injection appears to be an effective and safe procedure for the treatment of postcatheterization pseudoaneurysms.

• Authors: E R Hendriks, H van Overhagen, C M Bruijninckx, A M Wiersema
• Journal: Nederlands tijdschrift voor geneeskunde (Ned Tijdschr Geneeskd) Vol. 144 Issue 51 Pg. 2455-9 (Dec 16 2000) ISSN: 0028-2162 [Print] Netherlands
• Vernacular Title: Echogeleide percutane trombine-injectie ter behandeling van een vals aneurysma in de lies of arm na katheterisatie; gunstige resultaten bij 14 patiënten.
• PMID: 11151655 (Publication Type: Journal Article)

Chemical References

• Hemostatics
• Thrombin

Topics

• Administration, Cutaneous
• Aged
• Aneurysm, False (diagnostic imaging, drug therapy, etiology)
• Brachial Artery
• Catheterization, Peripheral (adverse effects)
• Female
• Femoral Artery
• Hemostatics (administration & dosage)
• Humans
• Male
• Middle Aged
• Prospective Studies
• Recurrence
• Thrombin (administration & dosage)
• Treatment Outcome
• Ultrasonography