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


METHODS
Prospective.


METHODS
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.


CONCLUSIONS
Percutaneous thrombin injection appears to be an effective and safe procedure for the treatment of postcatheterization pseudoaneurysms.
Hendriks
E R
ER
Afd. Heelkunde, Ziekenhuis Leyenburg, Postbus 40.551, 2504 LN Den Haag.
van Overhagen
H
H
Bruijninckx
C M
CM
Wiersema
A M
AM
D000279:Administration, Cutaneous; D000368:Aged; D017541:Aneurysm, False / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000209:etiology; D001916:Brachial Artery; D002406:Catheterization, Peripheral / Q000009:adverse effects*; D005260:Female; D005263:Femoral Artery; D006490:Hemostatics / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D013917:Thrombin / Q000008:administration & dosage*; D016896:Treatment Outcome; D014463:Ultrasonography
D006490:Hemostatics; D013917:Thrombin