Treatment of Iatrogenic Femoral Pseudoaneurysms with Ultrasonography by Thrombin Injection: Single Center Results

Objective: The aim of this study is to investigate the efficacy of ultrasound guided percutaneous thrombin injection in the treatment of pseudoaneurysm and to present the results of our clinic accompanied with the literature. Material and Methods: 58 patients (28 males, 30 females, 64, 2 +/- 7.8 years) with iatrogenic femoral pseudoaneurysm between January 2016 and June 2018, were included in our study. 62 lesions were treated with ultrasound guided percutaneous thrombin (Tisseel, Baxter US) injection. Demographic characteristics of the patients and the pseudoaneurysm features were recorded, and the effectiveness and reliability of the procedure were examined. Results: The pseudoaneurysms were originated respectively, 43% (n; 27) from common femoral artery, 52% (n: 32) from superficial femoral artery and 5% (n: 3) from deep femoral artery. The mean maximum transverse diameter of the pseudoaneurysms was 41.4 +/- 12.1 (21-76) mm. Mean neck diameter was 1.6 +/- 0.49 (1-3) mm. Technical success was determined as 100% since no filling with colour was observed in the Doppler control performed immediately after the embolization procedure. At the control exam performed 24 hours after the procedure, it was seen that 6 of the 62 pseudoaneurysms (9,6%) still filled with colour. Due to this, clinical success was evaluated as 90.4%. Same procedure was applied over again to the persistent lesions, and filling with colour was observed in none of the remaining pseudoaneurysms after that. No complication was detected in the patients after embolisation. Conclusion: Ultrasound guided thrombin injection is a usefull method in the treatment of iatrogenic femoral pseudoaneurysms, which is very effective and easy to apply. In addition to this, it is a safe and well tolerated method for patients.