Comparison of Ultrasound-Guided Thrombin Injection of Iatrogenic Pseudoaneurysms Based on Neck Dimension
| Autor: | Jorge Rey, Priscila G. Sanchez, Keith M. Jones, Ethan Y. Yang, Jaimin Patel, Andrew M. Abi-Chaker, Marwan Tabbara, Arash Bornak |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Iatrogenic Disease Aneurysm neck Short neck Femoral artery 030204 cardiovascular system & hematology 030218 nuclear medicine & medical imaging 03 medical and health sciences Pseudoaneurysm 0302 clinical medicine medicine.artery Catheterization Peripheral Humans Medicine In patient cardiovascular diseases Ultrasonography Doppler Color Ultrasonography Interventional Retrospective Studies Groin business.industry Endovascular Procedures Ultrasound Thrombin General Medicine medicine.disease Ultrasound guided Surgery Femoral Artery medicine.anatomical_structure Injections Intra-Arterial cardiovascular system Female Radiology Cardiology and Cardiovascular Medicine business Aneurysm False |
| Zdroj: | Annals of Vascular Surgery. 47:121-127 |
| ISSN: | 0890-5096 |
| DOI: | 10.1016/j.avsg.2017.07.029 |
| Popis: | Background Ultrasound-guided thrombin injection (UGTI) of femoral artery pseudoaneurysms after endovascular procedures is an effective therapy. There is controversy in the literature regarding injecting pseudoaneurysms with short and/or wide necks. This article reports our experience in UGTI of pseudoaneurysms in 1 hospital regarding the efficacy of this treatment in all pseudoaneurysms regardless of the size of the necks. Methods A retrospective review of 46 patients diagnosed between 2011 and 2016 with groin pseudoaneurysms using established duplex ultrasound criteria. Mean age was 68 years (range 27–87). Ten pseudoaneurysms thrombosed spontaneously, 5 were thrombosed by ultrasound-guided compression, and 2 were treated surgically due to disqualifying criteria. In this retrospective review, we analyzed the remaining 29 pseudoaneurysms regarding the dimensions of their neck lengths and outcomes after attempting thrombin injection. Results The mean aneurysm neck length and width were 1.03 ± 0.9 cm and 0.30 ± 0.1 cm, respectively. All 29 patients were evaluated with respect to pseudoaneurysm size, neck length, neck width, and complexity. Successful treatment of 29 pseudoaneurysms (2 external iliac, 20 common femoral, 2 deep femoral, and 5 superficial femoral) with UGTI was achieved without complications in 100% of the cases, regardless of pseudoaneurysm size, neck dimensions, or complexity. Anticoagulation status did not affect the efficacy of the procedure. Nine of the 29 pseudoaneurysms (31.0%) had neck length less than 0.5 cm. Conclusions This study demonstrates the safety and efficacy of UGTI in treating iatrogenic pseudoaneurysm in 29 of 29 patients, even in patients with pseudoaneurysm with short neck lengths. Our experiences support injecting all pseudoaneurysms irrespective of dimension. |
| Databáze: | OpenAIRE |
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