Efficacy and Rationale of Endoscopic Ultrasound-Guided Thrombin Injection in Visceral Artery Pseudoaneurysm Not Amenable to Angioembolization.

Autor:	Jhajharia A; From the Department of Gastroenterology, SMS Medical College and Hospital., Singh S; From the Department of Gastroenterology, SMS Medical College and Hospital., Chaudhary M; Department of Radiology, Santokba Durlabhji Memorial Hospital, Jaipur, India., Ameta M; From the Department of Gastroenterology, SMS Medical College and Hospital., Ashdhir P; From the Department of Gastroenterology, SMS Medical College and Hospital., Nijhawan S; From the Department of Gastroenterology, SMS Medical College and Hospital.
Jazyk:	angličtina
Zdroj:	Pancreas [Pancreas] 2024 Apr 01; Vol. 53 (4), pp. e330-e337. Date of Electronic Publication: 2024 Feb 12.
DOI:	10.1097/MPA.0000000000002303
Abstrakt:	Background: Pseudoaneurysm usually occurs after vascular injuries or erosions such as in trauma or inflammation like pancreatitis and is associated with high morbidity and mortality. Aim: The aim of study is to assess efficacy and safety of EUS-guided thrombin injection in pseudoaneurysm. Materials and Methods: Prospective data collection was done at SMS Hospital, Jaipur, from January 2015 to March 2023. All patients with pseudoaneurysm were consecutively enrolled. Results: Twenty patients (M/F, 18:2) with median age of 41 years (25-58 years), were studied. Underlying etiology of pseudoaneurysm was chronic pancreatitis in 75% of the patients, blunt trauma abdomen in 15% of the patients, recurrent acute pancreatitis in 5%, and idiopathic in 5% of the patients. At the time of admission, mean hemoglobin was 6.7 g/dL (3.4-8.2), with median blood transfusion requirement was 2 units (0-6 units). Hemoglobin values after 4-6 weeks showed a significant improvement ( t = 9.21, P < 0.05).Mean dose of human thrombin required for complete obliteration of pseudoaneurysm was 520 ± 188.6 IU per patient (300-800 IU). Amount of thrombin (IU) dose needed to achieve complete obliteration correlated well significantly with the dimension of pseudoaneurysm, P value less than 0.05 ( R = 0.80). Median follow-up duration in this study was 44 months (3-84 months), which was the longest follow-up period by far. Conclusions: Endoscopic ultrasound-guided thrombin injection in visceral artery pseudoaneurysm is a safe and effective alternative for patients not amenable for digital subtraction angiography-guided angioembolization. Competing Interests: Disclosure statement: The authors declare that no conflict of interest exists. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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