title: US-guided percutaneous thrombin injection of postcatheterization pseudoaneurysms.
abstract: OBJECTIVE
  This study retrospectively evaluated ultrasonography-guided (US-guided) percutaneous thrombin injection for the treatment of postcatheterization femoral and brachial artery pseudoaneurysms.
  
  
  METHODS
  Fifty-five patients with postcatheterization femoral artery (n = 53) or brachial artery (n = 2) pseudoaneurysms were treated using US-guided human thrombin (500 IU/mL) injection. Pseudoaneurysm size, thrombin dose, therapy outcome, and complications were documented. Follow-up color Doppler US was performed 7 and 30 days after treatment. Short-duration supplemental compression was applied to six patients at the first week follow-up examination after a reinjection of thrombin had failed.
  
  
  RESULTS
  Mean pseudoaneurysm volume was 20.3 ± 18.7 cm(3). The mean injected thrombin dose was 478 ± 238 IU. Thirty-eight (69.1%) of the 55 pseudoaneurysms were thrombosed with a single injection, and 11 of 17 pseudoaneurysms were thrombosed after a second injection. All (100%) of the 41 pseudoaneurysms that were diagnosed within the first two weeks of postcatheterization were successfully treated. The overall primary success rate was 89.1% (49 of 55 pseudoaneurysms). Supplemental compression promoted thrombosis in four of the six patients who had treatment failure with thrombin injection. The secondary success rate was 96.4% (53 of 55 pseudoaneurysms). There were no complications.
  
  
  CONCLUSIONS
  US-guided thrombin injection was most successful within the first two weeks, and the supplemental compression might aid in the closure of partially thrombosed pseudoaneurysms.
authors.affiliation: Department of Radiology, Abant İzzet Baysal University School of Medicine, Bolu, Turkey. kamilgurel@hotmail.com
authors.forename: Kamil
authors.initials: K
authors.lastname: Gürel
authors.forename: Serkan
authors.initials: S
authors.lastname: Gür
authors.forename: Uğur
authors.initials: U
authors.lastname: Özkan
authors.forename: Güven
authors.initials: G
authors.lastname: Tekbaş
authors.forename: Hakan
authors.initials: H
authors.lastname: Önder
authors.forename: Levent
authors.initials: L
authors.lastname: Oğuzkurt
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017541:Aneurysm, False / Q000188:drug therapy* / Q000209:etiology; D001916:Brachial Artery / Q000000981:diagnostic imaging*; D002404:Catheterization / Q000009:adverse effects; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging*; D006801:Humans; D007267:Injections / Q000379:methods; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013917:Thrombin / Q000008:administration & dosage*; D018084:Ultrasonography, Interventional
chemical_list: D013917:Thrombin