[Usefulness of sonographically guided thrombin injection of iatrogenic femoral pseudoaneurysms].
OBJECTIVE
In december 2000, we began to treat iatrogenic femoral pseudoaneurysms with direct thrombin injection under sonographic guidance after failed sonographically guided compression repair. Our purpose was to determine the success and complications rate of this technique.


METHODS
We treated 50 patients who had iatrogenic femoral pseudoanerysms using direct thrombin injection. A 22-gauge spinal needle was placed into the psudoaneurysm lumen with sonographic guidance, and bovine thrombin (mean dose, 1200 units; range 200-7000 units) was injected under continous color Doppler sonographic visualization. Patient demographics clinical variables, and pseudoaneurysms characteristics were collected.


RESULTS
The overall success rate was 98% (49/50). 30 patiens only required one thrombin injection, with mean thrombosis time of 4 s. When more than one injection was required the mean thrombosis time increased to 9,5 s. There was correlation between thrombosis time and the pseudoaneurysm size (p < 0.005); and between pseudoaneurysm size and the dose of thrombin used. No mayor sedation was needed and no recurrent pseudoaneurysms were observed. With the exception of a mild local eritema in one patient no complications were found.


CONCLUSIONS
The thrombin injection under sonographic guidance is a quick, effective and secure method of therapy for the treatment of iatrogenic femoral pseudoaneurysms. Failures and complications are infrequents. At our hospital sonographically guided thrombin injection had replaced compression repair.
Vázquez
Victoria
V
Servicio de Radiología. Hospital Universitario Virgen de la Arrixaca. Murcia. Spain.
Reus
Manuel
M
Morales
M Dolores
MD
Abellán
José
J
Piñero
Antonio
A
Soria
Federico
F
Parrilla
Pascual
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D006328:Cardiac Catheterization / Q000009:adverse effects; D018618:Echocardiography, Doppler, Color; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000187:drug effects*; D006490:Hemostatics / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007049:Iatrogenic Disease; D007269:Injections, Intra-Arterial / Q000379:methods*; D008297:Male; D008875:Middle Aged; D013917:Thrombin / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
D006490:Hemostatics; D013917:Thrombin