[Non-surgical therapy of iatrogenic false aneurysms].
False aneurysms occur after 0.1 - 1.5 % of all diagnostic and up to 6 % of all therapeutic percutaneous interventions. Surgery used to be the treatment of choice in symptomatic patients. But two non-invasive measures of treatment gain more attention: ultrasound guided compression (UGC) and ultrasound guided thrombin injection (UGTI). UGC with compression times from 30 - 120 min is effective in 80 % of patients without anticoagulation. However, UGC is often painful and results in prolongation of in-hospital time. UGTI is effective in 95 % of patients. Usually, 100 - 2000 U of thrombin are injected into the false aneurysm. UGTI is also effective in the presence of anticoagulation or antiplatelet therapy. UGTI is not indicated in patients with a large communication with the native vessel and in arterio-venous-fistulas. In patients with large haematomas, ongoing bleeding, damage of the native vessel, compression of arteries, veins or neurological deficits, or with infections, early surgical repair is still the treatment of choice.
Görge
G
G
Medizinische Klinik II, Klinikum Saarbrücken, Germany. g.gorge@mx.uni-saarland.de
Kunz
T
T
Kirstein
M
M
D017541:Aneurysm, False / Q000175:diagnosis / Q000628:therapy*; D003937:Diagnosis, Differential; D006801:Humans; D007049:Iatrogenic Disease