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Related Experiment Videos

Femoral pseudoaneurysm thrombinjection.

S S Gale1, R P Scissons, L Jones

  • 1Jobst Vascular Center, 2109 Hughes Drive, Suite 400, Toledo, Ohio 43606, USA. sgale@jvc.org

American Journal of Surgery
|July 5, 2001
PubMed
Summary

Thrombin injection effectively treats pseudoaneurysms after catheterization. Careful technique, including slow injection and ultrasound guidance, ensures successful thrombosis and minimizes risks.

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Area of Science:

  • Cardiovascular Medicine
  • Interventional Radiology

Background:

  • Pseudoaneurysms (PSA) are a complication of cardiovascular catheterization.
  • Thrombin injection offers an effective and economical alternative to compression or surgery for PSA treatment.
  • Concerns about systemic arterial thrombosis have limited widespread adoption of thrombin injection.

Purpose of the Study:

  • To report on cautionary steps and lessons learned from the first 20 cases of thrombin injection for pseudoaneurysm treatment.
  • To evaluate the efficacy and safety of ultrasound-guided thrombin injection for pseudoaneurysms.

Main Methods:

  • Twenty patients (12 women, 8 men) with femoral pseudoaneurysms underwent ultrasound-guided thrombin injection.
  • Thrombin (100-2,300 units) was slowly injected into the pseudoaneurysm sac, avoiding the neck.

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  • Key techniques included slow injection, thrombus ball positioning, and probe compression using ultrasound.

    • Main Results:

    • All pseudoaneurysms successfully thrombosed on the first treatment.
    • Pseudoaneurysm sizes ranged from 17-39 mm with neck openings of 1.5-3.9 mm.
    • One patient experienced fever; another required compression for a separate pseudoaneurysm.

    Conclusions:

    • Successful thrombin injection is achievable for common femoral artery pseudoaneurysms with small neck openings.
    • Avoiding arteriovenous fistulas and employing specific techniques like slow injection and probe compression are crucial.
    • Standard thrombin concentration and advanced ultrasonography contribute to successful outcomes.