[Treatment of iatrogenic femoral pseudoaneurysms with thrombin injection--results in 54 patients].
OBJECTIVE
To evaluate ultrasound-guided percutaneous thrombin injection to treat iatrogenic femoral pseudoaneurysms following catheter interventions.


METHODS
In a period of 2 years and 11 months, 55 iatrogenic femoral pseudoaneurysms were treated in 54 patients (male : female = 29 : 25) by percutaneous thrombin injection under continuous color Doppler control. Mean maximum diameter of the perfused lumen was 2.5 cm (SD +/- 1 cm). The injected thrombin doses varied between 10 and 2,000 U (median 200 U).


RESULTS
Following thrombin injection, the pseudoaneurysm occlusion rate was 100 % (n = 55/55). Complete and persistent occlusion was achieved in 54 of 55 (98 %) pseudoaneurysms. A repeated procedure was necessary in 6 pseudoaneurysms. In one case (2 %), discrete signs of reperfusion were observed after primary occlusion within 24 hours of the initial procedure (lumen diameter 3 x 5 mm), followed by spontaneous thrombosis without further treatment. No complications, in particular no clinically manifest thromboembolic events, were observed.


CONCLUSIONS
Ultrasound-guided percutaneous thrombin injection is an effective and safe method for the treatment of iatrogenic post catheterization femoral pseudoaneurysms.
Demharter
J
J
Klinik für Diagnostische Radiologie und Neuroradiologie, Zentralklinikum Augsburg. johannes.demharter@radiolgie.zk.augsburg-med.de
Leissner
G
G
Huf
V
V
Roemer
F W
FW
Vollert
K
K
Bohndorf
K
K
D000368:Aged; D000369:Aged, 80 and over; D017541:Aneurysm, False / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging* / Q000187:drug effects*; D006490:Hemostatics / Q000008:administration & dosage; D006801:Humans; D007049:Iatrogenic Disease / Q000517:prevention & control*; D007267:Injections / Q000379:methods*; D008297:Male; D008875:Middle Aged; D025321:Surgery, Computer-Assisted / Q000379:methods; D013917:Thrombin / Q000008:administration & dosage*; D016896:Treatment Outcome; D014463:Ultrasonography
D006490:Hemostatics; D013917:Thrombin