E-ISSN 1305-3612
Interventional Radiology - Original Article
US-guided percutaneous thrombin injection of postcatheterization pseudoaneurysms
1 Department of Radiology, Abant İzzet Baysal University School of Medicine, Bolu, Turkey.  
2 Department of Radiology, Şifa Hospital, İzmir, Turkey.  
3 Department of Radiology , Başkent University School of Medicine Research and Training Hospital, Adana, Turkey.  
4 Department of Radiology, Dicle University School of Medicine, Diyarbakır, Turkey  
5 Department of Radiology, Bahçelievler Medical Park Hospital, İstanbul, Turkey  
Diagn Interv Radiol 2012; 18: 319-325
DOI: 10.4261/1305-3825.DIR.4933-11.1
Key Words: pseudoaneurysm • therapeutic embolization• thrombin
Abstract

PURPOSE
This study retrospectively evaluated ultrasonography-guided (US-guided) percutaneous thrombin injection for the treatment of postcatheterization femoral and brachial artery pseudoaneurysms.

 

MATERIALS AND METHODS
Fifty-five patients with postcatheterization femoral artery (n=53) or brachial artery (n=2) pseudoaneurysms were treated using US-guided human thrombin (500 IU/mL) injection. Pseudoaneurysm size, thrombin dose, therapy outcome, and complications were documented. Follow-up color Doppler US was performed 7 and 30 days after treatment. Short-duration supplemental compression was applied to six patients at the first week follow-up examination after a reinjection of thrombin had failed.

 

RESULTS
Mean pseudoaneurysm volume was 20.3±18.7 cm3. The mean injected thrombin dose was 478±238 IU. Thirty-eight (69.1%) of the 55 pseudoaneurysms were thrombosed with a single injection, and 11 of 17 pseudoaneurysms were thrombosed after a second injection. All (100%) of the 41 pseudoaneurysms that were diagnosed within the first two weeks of postcatheterization were successfully treated. The overall primary success rate was 89.1% (49 of 55 pseudoaneurysms). Supplemental compression promoted thrombosis in four of the six patients who had treatment failure with thrombin injection. The secondary success rate was 96.4% (53 of 55 pseudoaneurysms). There were no complications.

 

CONCLUSION
US-guided thrombin injection was most successful within the first two weeks, and the supplemental compression might aid in the closure of partially thrombosed pseudoaneurysms.

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