Abstract 15588: Results of Percutaneus Ultrasound Guided Thrombin Injection in 404 Patients with Postcatherization Pseudo Aneurysm
Purpose: To audit our experience with ultrasound and biopsy line guided human thrombin injection for the treatment of iatrogenic femoral pseudo aneurysms (PA) following minimal invasive coronary artery or peripheral vascular intervention.
Methods: A retrospective study of 404 consecutive patients (229 female) undergoing percutaneus US guided human thrombin injection during the period of April 2002 to May 2012 was performed. Primary and secondary success rates of the treatment and adverse clinical events (AEs) following human thrombin injection like local infections, massive pain, deep vein thrombosis (DVT), allergic reaction, iatrogenic embolic complications and need of surgical interventions were recorded
Results: Mean PA volume was 12.7 cm³ (25.9; standard deviation). Simple and complex PA were treated in 247 and 157 patients. Within the first attempt 523 thrombin injections were performed: 1.25 per patient with simple PA and 1.46 per patient with complex PA (p<0.001). Mean dose of human thrombin injected was 246.7 IU (146.2) for simple and 294.7 IU (188.3) for complex PA. Primary success rate was 77.7% and secondary success rate was 93.8%. AEs occurred in 9.4% (n=38) treated patients (local infections: 6, massive pain: 2, DVT:5, allergic reaction: 1, embolic complications: 2, surgical interventions: 22). A significant correlation was noticed between number of thrombin injections needed and the incidence of AE (p=0.045).
Conclusion: According to our real life experience in the treatment of PA we highly recommend ultrasound and biopsy line guided thrombin injection as first-line treatment. It is a quick, reliable and safe treatment of iatrogenic femoral pseudo aneurysms.
- © 2012 by American Heart Association, Inc.