Thrombin injection for treatment of brachial artery pseudoaneurysm at the site of a hemodialysis fistula: report of two patients.
We report two patients with arteriovenous hemodialysis fistulas that were complicated by brachial artery pseudoaneurysms. Each pseudoaneurysm was percutaneously thrombosed with an injection of thrombin, using techniques to prevent escape of thrombin into the native brachial artery. In one patient, an angioplasty balloon was inflated across the neck of the aneurysm during thrombin injection. In the second patient, thrombin was injected during ultrasound-guided compression of the neck of the pseudoaneurysm. Complete thrombosis of each pseudoaneurysm was achieved within 30 sec. No ischemic or embolic events occurred. This technique may be useful in treating pseudoaneurysms of smaller peripheral arteries.
Clark
T W
TW
Section of Interventional Radiology, Department of Diagnostic Imaging, Dalhousie University, Queen Elizabeth II Health Sciences Centre, 1796 Summer Street, Halifax, Nova Scotia, Canada B3H 2Y9. clark@oasis.rad.upenn.edu
Abraham
R J
RJ
D000328:Adult; D000368:Aged; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy*; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D001916:Brachial Artery; D003029:Coagulants / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007269:Injections, Intra-Arterial; D008297:Male; D015641:Radiography, Interventional; D006435:Renal Dialysis / Q000009:adverse effects*; D013917:Thrombin / Q000627:therapeutic use*
D003029:Coagulants; D013917:Thrombin