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Iatrogenic pseudoaneurysms: comparison of treatment modalities, including duplex-guided thrombin injection

Patrick Stone1, James A Lohan, Stacey E Copeland

  • 1West Virginia University School of Medicine, Charleston Division, USA.

The West Virginia Medical Journal
|March 12, 2004
PubMed

Insights

Duplex-guided thrombin injection (DGTI) is highly effective for treating iatrogenic pseudoaneurysms, with a 96% success rate. Ultrasound-guided compression (UGC) is less successful, making DGTI the preferred initial treatment.

Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Medical Device Technology

Background:

  • Iatrogenic pseudoaneurysms are a potential complication of vascular interventions.
  • Current treatment options include ultrasound-guided compression (UGC), duplex-guided thrombin injection (DGTI), and open operative repair.
  • Evaluating the efficacy of these modalities is crucial for optimizing patient outcomes.

Purpose of the Study:

  • To review and compare the results of three treatment modalities for iatrogenic pseudoaneurysms at Charleston Area Medical Center (CAMC).
  • To determine the most effective treatment approach for pseudoaneurysms.

Main Methods:

  • Retrospective review of patient records treated for pseudoaneurysms between July 1, 2001, and June 30, 2002.
  • Analysis of treatment success rates for UGC, DGTI, and open operative repair.
  • Comparison of procedural times and blood loss for operative repair.

Main Results:

  • Out of 47 femoral pseudoaneurysms, UGC successfully treated 57% (27/47).
  • DGTI achieved a 96% success rate (26/27), including cases where UGC failed.
  • Open operative repair was required for 17 patients, primarily after failed non-operative treatments.

Conclusions:

  • Duplex-guided thrombin injection (DGTI) demonstrates superior efficacy compared to ultrasound-guided compression (UGC) for iatrogenic pseudoaneurysms.
  • DGTI should be considered the initial treatment of choice.
  • Operative therapy should be reserved for cases refractory to non-operative interventions like DGTI.

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