Outcomes of Ultrasound-Guided Thrombin Injection of Nongroin Arterial Pseudoaneurysms.

Abstract

PURPOSE:

To evaluate success and complication rates of percutaneous ultrasound-guided thrombin injection of nongroin pseudoaneurysms (PSAs).

MATERIALS AND METHODS:

Retrospective review of a prospectively maintained institutional database yielded 39 cases of arterial PSAs occurring at nongroin sites that were treated with percutaneous ultrasound-guided thrombin injection between 2000 and 2016 (average patient age 69.2 y ± 14.0). Of PSAs, 74.4% (29/39) arose in the upper extremities, and 92.3% (36/39) were iatrogenic. The brachial artery was the most commonly affected vessel (51.3% [20/39]), and arterial access was the most common cause (56.4% [22/39]). Average overall PSA size was 2.4 cm (range, 0.5-7.2 cm); average amount of thrombin injected was 320 IU (range, 50-2,000 IU). Technical success was defined as absence of flow within the PSA immediately after thrombin injection. Treatment success was defined as sustained thrombosis on follow-up imaging obtained at 1-3 days after treatment.

RESULTS:

Technical and treatment success rates of thrombin injections were 100% (39/39) and 84.8% (28/33), respectively. Longer term follow-up imaging (average 71 d; range, 12-201 d) was available for 7 of the treatment successes with 100% (7/7) showing sustained thrombosis. Comparing treatment successes and failures, there was no significant difference in average PSA size (2.3 cm vs 2.0 cm, P = .51) or average amount of thrombin injected (360 IU vs 180 IU, P = .14). There were no complications.

CONCLUSIONS:

Ultrasound-guided thrombin injection is a safe, efficacious treatment option for PSAs arising in nongroin locations.

• Authors: Johnathan C Valesano, John J Schmitz, A Nicholas Kurup, Grant D Schmit, Michael R Moynagh, Thomas D Atwell, Bradley D Lewis, Robert A Lee, Matthew R Callstrom
• Journal: Journal of vascular and interventional radiology : JVIR (J Vasc Interv Radiol) Vol. 28 Issue 8 Pg. 1156-1160 (Aug 2017) ISSN: 1535-7732 [Electronic] United States
• PMID: 28578990 (Publication Type: Journal Article)
• Copyright: Copyright © 2017 SIR. Published by Elsevier Inc. All rights reserved.

Chemical References

• Thrombin

Topics

• Aged
• Aneurysm, False (drug therapy)
• Brachial Artery
• Female
• Humans
• Iatrogenic Disease
• Male
• Retrospective Studies
• Thrombin (therapeutic use)
• Treatment Outcome
• Ultrasonography, Interventional