title: Ultrasound-guided percutaneous thrombin injection for post-catheterization pseudoaneurysm.
abstract: BACKGROUND
  The efficacy and safety of ultrasound-guided thrombin injection (UGTI) for the treatment of post-catheterization femoral and brachial artery pseudoaneurysms (PSA) is unclear in Japan.
  
  
  RESULTS
  A retrospective study of 32 consecutive patients undergoing percutaneous UGTI of post-catheterization PSA between February 2011 and February 2014 was performed. There were 23 femoral PSA and 9 brachial PSA treated with UGTI. The prevalence of CAD and smoking history were higher in the brachial PSA patients, but there were no statistically significant differences in other patient demographic factors or in the preprocedural antiplatelet therapy between the femoral and brachial PSA patients. The median dose of thrombin injected was 200 U (range, 100-600 U). The initial success rate, early recurrence rate and surgical conversion rate were 91%, 0% and 4% in the femoral PSA, and 89%, 11% and 11% in the brachial PSA, respectively. There were 2 cases of medial nerve compression in the brachial PSA group, but there were no complications in the femoral PSA group (P=0.0198). On outpatient clinical follow-up in the successfully treated patients, there were no recurrences after an average follow-up of 16 months.
  
  
  CONCLUSIONS
  UGTI is a feasible, safe and effective less-invasive treatment for post-catheterization PSA. Brachial PSA, however, might require additional attention because of their tendency toward higher recurrence and complications.
authors: Department of Vascular Surgery, Kokura Memorial Hospital.
authors: Sosei
authors: S
authors: Kuma
authors: Koichi
authors: K
authors: Morisaki
authors: Akio
authors: A
authors: Kodama
authors: Atsushi
authors: A
authors: Guntani
authors: Ryota
authors: R
authors: Fukunaga
authors: Yoshimitsu
authors: Y
authors: Soga
authors: Shinichi
authors: S
authors: Shirai
authors: Masaru
authors: M
authors: Ishida
authors: Jin
authors: J
authors: Okazaki
authors: Shinsuke
authors: S
authors: Mii
mesh_terms: D000368:Aged; D017541:Aneurysm, False / Q000150:complications / Q000188:drug therapy* / Q000209:etiology / Q000601:surgery; D000792:Angiography / Q000009:adverse effects; D001916:Brachial Artery / Q000293:injuries*; D003131:Combined Modality Therapy; D057510:Endovascular Procedures / Q000009:adverse effects; D005260:Female; D005263:Femoral Artery / Q000293:injuries*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D009408:Nerve Compression Syndromes / Q000209:etiology; D011677:Punctures / Q000009:adverse effects; D012008:Recurrence; D012189:Retrospective Studies; D013917:Thrombin / Q000008:administration & dosage / Q000627:therapeutic use*; D018084:Ultrasonography, Interventional; D062666:Vascular Access Devices / Q000009:adverse effects*; D014656:Vascular Surgical Procedures
chemical_list: D013917:Thrombin