Obliteration of femoral artery pseudoaneurysm by thrombin injection.
BACKGROUND
Femoral artery pseudyoaneurysms are a common complication after femoral access for transcatheter procedures, frequently requiring operative repair. We review the safety and efficacy of a novel nonsurgical method of pseudoaneurysm treatment


METHODS
From June 1998 to November 2001, a total of 47 femoral artery pseudoaneurysms in 46 patients were treated by bedside ultrasound-guided injection of dilute topical thrombin. All pseudoaneurysms occurred after femoral access for transcatheter procedures, and were diagnosed clinically and confirmed with ultrasound imaging. Clinical follow-up was performed and included ultrasound (2 hours to 1 month) in 64.4% of patients, including any patient with a symptomatic or clinical change.


RESULTS
Pseudoaneurysms ranged in size from 1.5 to 4.5 cm. Of 47 pseudoaneurysms, 45 were successfully obliterated on the initial injection. After successful obliteration of pseudoaneurysm, 1 patient sustained thrombosis of the tibioperoneal trunk that required surgical embolectomy, yielding a complication rate of 2%. Four pseudoaneurysms recurred after initially successful obliteration. In 1 of these cases, the patient was taken directly to surgery, and 3 were successfully treated with repeat injection, for an overall success rate of 93.6%.


CONCLUSIONS
Obliteration of femoral artery pseudoaneurysm by injection is safe and effective, and may be associated with decreased morbidity. Recurrent pseudoaneurysms may be safely reinjected, with a high success rate.
Edgerton
James R
JR
Cardiopulmonary Research Science and Technology Institute, Dallas, Texas, USA. edgertonjr@aol.com
Moore
David O
DO
Nichols
Donna
D
Lane
B Ward
BW
Magee
Mitchell J
MJ
Dewey
Todd M
TM
Mack
Michael J
MJ
D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000188:drug therapy*; D002404:Catheterization / Q000009:adverse effects*; D005263:Femoral Artery; D006801:Humans; D007267:Injections; D012008:Recurrence; D013917:Thrombin / Q000008:administration & dosage*; D016896:Treatment Outcome; D014463:Ultrasonography
D013917:Thrombin