Obliteration of femoral artery pseudoaneurysm by thrombin injection.

Abstract

BACKGROUND:

Femoral artery pseudyoaneurysms are a common complication after femoral access for transcatheter procedures, frequently requiring operative repair. We review the safety and efficacy of a novel nonsurgical method of pseudoaneurysm treatment

METHODS:

From June 1998 to November 2001, a total of 47 femoral artery pseudoaneurysms in 46 patients were treated by bedside ultrasound-guided injection of dilute topical thrombin. All pseudoaneurysms occurred after femoral access for transcatheter procedures, and were diagnosed clinically and confirmed with ultrasound imaging. Clinical follow-up was performed and included ultrasound (2 hours to 1 month) in 64.4% of patients, including any patient with a symptomatic or clinical change.

RESULTS:

Pseudoaneurysms ranged in size from 1.5 to 4.5 cm. Of 47 pseudoaneurysms, 45 were successfully obliterated on the initial injection. After successful obliteration of pseudoaneurysm, 1 patient sustained thrombosis of the tibioperoneal trunk that required surgical embolectomy, yielding a complication rate of 2%. Four pseudoaneurysms recurred after initially successful obliteration. In 1 of these cases, the patient was taken directly to surgery, and 3 were successfully treated with repeat injection, for an overall success rate of 93.6%.

CONCLUSIONS:

Obliteration of femoral artery pseudoaneurysm by injection is safe and effective, and may be associated with decreased morbidity. Recurrent pseudoaneurysms may be safely reinjected, with a high success rate.

• Authors: James R Edgerton, David O Moore, Donna Nichols, B Ward Lane, Mitchell J Magee, Todd M Dewey, Michael J Mack
• Journal: The Annals of thoracic surgery (Ann Thorac Surg) Vol. 74 Issue 4 Pg. S1413-5 (Oct 2002) ISSN: 0003-4975 [Print] Netherlands
• PMID: 12400828 (Publication Type: Journal Article)

Chemical References

• Thrombin

Topics

• Aneurysm, False (diagnostic imaging, drug therapy)
• Catheterization (adverse effects)
• Femoral Artery
• Humans
• Injections
• Recurrence
• Thrombin (administration & dosage)
• Treatment Outcome
• Ultrasonography