title: Complications of percutaneous thrombin injection in patients with postcatheterization femoral pseudoaneurysm.
abstract: OBJECTIVE
  To study the complications of ultrasound-guided thrombin injection of pseudo-aneurysms occurring after interventional cardiovascular procedures.
  
  
  METHODS
  We prospectively studied 353 patients who developed post-catheterization femoral artery pseudo-aneurysms and were treated with ultrasound-guided thrombin injection.
  
  
  RESULTS
  Arterial micro-embolization occurred in 53 patients (15%) and pulmonary embolism in 1 patient (0.3%). None of the patients developed significant peripheral arterial embolism. The length of the communicating channel between the arterial lumen and the pseudo-aneurysm was inversely correlated with the risk of embolization (p < 0.0001). A 4.6 mm increase in channel length decreased the odds of embolization by 14%, and patients with a channel less than 2 mm long were at greater risk. Repeated thrombin injection also increased the risk of embolization (p = 0.02).
  
  
  CONCLUSIONS
  Thrombin injection for the treatment of post-catheterization femoral pseudo-aneurysm is feasible and safe, but it must be performed with caution, especially when the sac is directly communicating with the artery, or when success cannot be achieved with a single injection.
authors.affiliation: Świȩtokrzyskie Cardiology Center, Grunwaldzka 45, 25-736 Kielce, Poland.
authors.forename: Jacek
authors.initials: J
authors.lastname: Kurzawski
authors.affiliation: Świȩtokrzyskie Cardiology Center, Grunwaldzka 45, 25-736 Kielce, Poland.
authors.forename: Marcin
authors.initials: M
authors.lastname: Sadowski
authors.affiliation: Świȩtokrzyskie Cardiology Center, Grunwaldzka 45, 25-736 Kielce, Poland.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Janion-Sadowska
mesh_terms: D000368:Aged; D017541:Aneurysm, False / Q000188:drug therapy* / Q000209:etiology; D002406:Catheterization, Peripheral / Q000009:adverse effects*; D004617:Embolism / Q000150:complications*; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging; D006490:Hemostatics / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D007269:Injections, Intra-Arterial; D008875:Middle Aged; D011446:Prospective Studies; D012306:Risk; D013917:Thrombin / Q000008:administration & dosage* / Q000627:therapeutic use; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color / Q000379:methods*; D018084:Ultrasonography, Interventional / Q000379:methods*
chemical_list: D006490:Hemostatics; D013917:Thrombin
keywords: complication; femoral artery; pseudoaneurysm; thrombin injection