Ultrasound-guided percutaneous thrombin injection for post-catheterization pseudoaneurysm

Area of Science:

• Vascular Surgery
• Interventional Radiology
• Medical Devices

Background:

• Efficacy and safety of ultrasound-guided thrombin injection (UGTI) for post-catheterization femoral and brachial artery pseudoaneurysms (PSA) remains unclear in Japan.
• PSA are abnormal collections of blood that can form after arterial catheterization procedures.

Purpose of the Study:

• To evaluate the efficacy and safety of UGTI for treating post-catheterization femoral and brachial artery pseudoaneurysms (PSA) in a Japanese patient cohort.
• To compare outcomes between femoral and brachial PSA treated with UGTI.

Main Methods:

• Retrospective study of 32 consecutive patients undergoing percutaneous UGTI for PSA between February 2011 and February 2014.
• 23 femoral and 9 brachial PSA were treated.
• Patient demographics, procedural details, and outcomes were analyzed.

Main Results:

• Initial success rates were high for both femoral (91%) and brachial (89%) PSA.
• Femoral PSA had 0% early recurrence and 4% surgical conversion; brachial PSA had 11% early recurrence and 11% surgical conversion.
• Two cases of medial nerve compression occurred in the brachial PSA group, with no complications in the femoral group (P=0.0198).

Conclusions:

• UGTI is a feasible, safe, and effective less-invasive treatment for post-catheterization PSA.
• Brachial PSA may require additional attention due to a tendency for higher recurrence and complication rates compared to femoral PSA.