[Treatment of pseudoaneurysms with injection of thrombin].
OBJECTIVE
To introduce and assess the efficacy and risks associated with a new treatment method of post-catheterization pseudoaneurysms.


METHODS
Thrombin injection was indicated in patients with failure of compression therapy during 24 hours. Patients with a cavity volume < 1 cm3, with a pseudoaneurysm causing compression or haemorrhagic shock were excluded. A needle is introduced under local anaesthesia with ultrasound guidance, its tip is placed thoroughly in the centre of the cavity. Subsequently, under colour-flow mapping, thrombin solution with concentration of 1000 IU/ml is cautiously injected, which results in instantaneous thrombosis of the pseudoaneurysm cavity.


RESULTS
Thrombin injection was used in 17 patients during a period of 12 months. 12 of them were women, 6 patients with valvular disease, 2 after intervention and 5 anticoagulated. The method was successful in 16 patients. In 5 of them, a small residual cavity persisted, which was not suitable for re-injection, and was closed completely after a few minutes of compression by a ultrasound transducer. There were no thrombotic complications.


CONCLUSIONS
Although compression remains the method of choice, thrombin injection is a highly effective, quick and, with necessary precautions, safe alternative to surgical treatment of pseudoaneurysms, mainly in anticoagulated patients.
Vrsanský
M
M
Kardiologická klinika SUSCH Pod Krásnou hôrkou 1 833 48 Bratislava Slovenská republika. vrsansky@pobox.sk
Mad'aric
J
J
Vulev
I
I
Gocár
M
M
Mistrík
A
A
Riecanský
I
I
D000368:Aged; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D002406:Catheterization, Peripheral / Q000009:adverse effects; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000293:injuries; D006490:Hemostatics / Q000008:administration & dosage*; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D013917:Thrombin / Q000008:administration & dosage*; D018084:Ultrasonography, Interventional
D006490:Hemostatics; D013917:Thrombin