Thrombin injection for treatment of false aneurysms after failed compression therapy in patients on full-dose antiplatelet and heparin therapy.

Abstract

The aim of this study was to gauge the effectiveness of thrombin injection after failed manual compression in patients with false aneurysms receiving full-dose antiplatelet and heparin therapy. In consecutive patients with failed manual compression therapy (ultrasound-guided manual compression, compression bandage, or both), thrombin was injected under ultrasound guidance. In 23 patients, thrombin was injected into the false aneurysm (100-2,000 units; mean, 895 +/- 520 units). All patients were on aspirin (median dose, 100 mg/day), clopidogrel (median dose, 75 mg/day), and either heparin (n = 3) with a partial thromboplastin time (PTT) > 55 sec or weight-adjusted enoxaparine (0.1 ml per 10 kg; maximum, 1 ml/b.i.d.). Twelve patients had received an i.v. GB IIIb/IIa antagonist 11-72 hr prior to diagnosis of the aneurysm. The mean width of the false aneurysms was 20.8 +/- 3.2 mm (range, 8.0-52.0 mm), length 29.7 +/- 32.6 mm (range, 9.0-147 mm), and depth 19 +/- 9.1 mm (range, 5.1-35.5 mm). Thrombosis after thrombin injection occurred in 21 patients within seconds. One patient required a second injection the next day, one patient underwent surgery. Overall success rate was 96%. No in-hospital complications occurred. In patients with false aneurysms and failed compression therapy under full-dose aspirin, clopidogrel, and heparin, selective thrombin injection is highly effective and safe.

• Authors: Günter Görge, Thomas Kunz
• Journal: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions (Catheter Cardiovasc Interv) Vol. 58 Issue 4 Pg. 505-9 (Apr 2003) ISSN: 1522-1946 [Print] United States
• PMID: 12652502 (Publication Type: Journal Article)
• Copyright: Copyright 2003 Wiley-Liss, Inc.

Chemical References

• Anticoagulants
• Enoxaparin
• Heparin
• Thrombin

Topics

• Aged
• Aneurysm, False (diagnostic imaging, therapy)
• Anticoagulants (administration & dosage)
• Cohort Studies
• Dose-Response Relationship, Drug
• Drug Administration Schedule
• Embolization, Therapeutic (methods)
• Enoxaparin (administration & dosage)
• Female
• Follow-Up Studies
• Heparin (administration & dosage)
• Humans
• Male
• Middle Aged
• Pressure
• Prospective Studies
• Risk Assessment
• Thrombin (administration & dosage)
• Treatment Outcome
• Ultrasonography, Doppler, Color