Outcomes of Ultrasound-Guided Thrombin Injection of Nongroin Arterial Pseudoaneurysms

被引:8
作者
Valesano, Johnathan C. [1 ]
Schmitz, John J. [1 ]
Kurup, A. Nicholas [1 ]
Schmit, Grant D. [1 ]
Moynagh, Michael R. [1 ]
Atwell, Thomas D. [1 ]
Lewis, Bradley D. [1 ]
Lee, Robert A. [1 ]
Callstrom, Matthew R. [1 ]
机构
[1] Mayo Clin, Dept Radiol, 200 First St SW, Rochester, MN 55905 USA
关键词
POSTCATHETERIZATION PSEUDOANEURYSMS; TRANSFEMORAL APPROACH; ANGIOGRAPHY; ANGIOPLASTY; ANEURYSMS; ACCESS;
D O I
10.1016/j.jvir.2017.05.003
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
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.
引用
收藏
页码:1156 / 1160
页数:5
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