Treatment of iatrogenic femoral pseudoaneurysm by ultrasound-guided compression therapy and thrombin injection.
Development of an arterial pseudoaneurysm is a common complication following cardiac catheterization. We analyzed data from 6,300 patients who received left heart catheterization at our institution. One day after the procedure, approximately 10% of the patients were examined with duplex sonography. In 204 patients (3.0%), a pseudoaneurysm of the femoral artery was diagnosed. All patients underwent compression therapy. Thereby, 159 of the pseudoaneurysms could be treated successfully. The remaining 45 pseudoaneurysms had a maximal diameter of more than 1.5 cm. Forty-two patients underwent ultrasound and biopsy-line-guided thrombin injection without complications. This strategy resulted in a successful occlusion in 41 cases. Pseudoaneurysms smaller than 2 cm can be treated with compression therapy. Larger pseudoaneurysms can be occluded by thrombin injection using ultrasound guidance. Patients with a pseudoaneurysm with a wide "neck" should be treated surgically, because the risk of an arterial occlusion following thrombin injection cannot be excluded.
Luedde
Mark
M
Department of Cardiology, University of Heidelberg, Germany. mark.luedde@med.uni -heidelberg.de
Krumsdorf
Ulrike
U
Zehelein
Joerg
J
Ivandic
Boris
B
Dengler
Thomas
T
Katus
Hugo A
HA
Tiefenbacher
Christiane
C
D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D006328:Cardiac Catheterization / Q000009:adverse effects*; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000293:injuries*; D005500:Follow-Up Studies; D006489:Hemostatic Techniques; D006490:Hemostatics / Q000008:administration & dosage*; D006801:Humans; D007049:Iatrogenic Disease; D007269:Injections, Intra-Arterial; D011312:Pressure; D012189:Retrospective Studies; D013917:Thrombin / Q000008:administration & dosage*; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex
D006490:Hemostatics; D013917:Thrombin