Duplex-Directed Thrombin Injection as a Method to Treat Femoral Artery Pseudoaneurysms

Wixon, Christopher L.; Philpott, Jonathan M.; Bogey, William M.; Powell, Charles S.

doi:10.1016/s1072-7515(98)00204-x

Cited by 40 publications

(19 citation statements)

References 5 publications

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“…16 More recently, interest in the percutaneous use of thrombin for femoral false aneurysm occlusion has increased with several reports of small series of patients successfully treated in this fashion. [17][18][19] We undertook a prospective study of percutaneous thrombin injection to evaluate its efficacy and applicability in our institutions.…”

Section: Introductionmentioning

confidence: 99%

Treatment of Femoral Artery Pseudoaneurysms with Percutaneous Thrombin Injection

Morrison

Obrand

Steinmetz

et al. 2000

Annals of Vascular Surgery

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Section: Introductionmentioning

confidence: 99%

Treatment of Femoral Artery Pseudoaneurysms with Percutaneous Thrombin Injection

Morrison

Obrand

Steinmetz

et al. 2000

Annals of Vascular Surgery

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“…Iatrogenic femoral artery pseudoaneurysms occur following 0.2–0.5% of diagnostic angiography cases and in up to 8% of coronary interventions 1. Risk factors include obesity, advanced age, aberrant femoral vascular anatomy, and concurrent antiplatelet/anticoagulant treatment.…”

mentioning

confidence: 99%

Ultrasound guided percutaneous thrombin injection of iatrogenic femoral artery pseudoaneurysms after coronary angiography and intervention

Ferguson

Whatling

Martín

et al. 2001

Heart

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Ultrasound guided percutaneous thrombin injection has recently been described for the treatment of iatrogenic femoral pseudoaneurysms. Patient selection and technical aspects of this technique are still evolving and safety data, particularly after coronary intervention, remains limited. The percutaneous thrombin injection of femoral artery pseudoaneurysms in 13 consecutive patients, most of whom were receiving antiplatelet/anticoagulant treatment (aspirin 11, heparin 4, clopidogrel 6), is reported. Thrombin (1000 U/ml) was injected over several seconds until Doppler colour flow within the cavity ceased. The median dose of thrombin injected was 800 U (range 200-1000 U) and the treatment was successful in all cases without complication. In one case, thrombus was visualised within the arterial lumen immediately after thrombin injection, but this dissolved spontaneously within five minutes without evidence of embolisation. In contrast to ultrasound guided compression, percutaneous thrombin injection of femoral pseudoaneurysms is a rapid, well tolerated, and successful technique even in patients receiving antiplatelet/anticoagulant treatment. (Heart 2001;85:e5) Keywords: ultrasound guided percutaneous thrombin injection; iatrogenic femoral artery pseudoaneurysm Iatrogenic femoral artery pseudoaneurysms occur following 0.2-0.5% of diagnostic angiography cases and in up to 8% of coronary interventions.

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“…Previous investigators demonstrated the efficacy and safety of an alternative approach to the repair of postcatheterization pseudoaneurysms using US guided thrombin injection [11][12][13]. Naidu et al [14] reported a case of percutaneous embolization of a lumbar pseudoaneurysm in a patient with type IV Ehlers-Danlos syndrome using nbutyl cyanoacrylate and coils via a US guided lumbar approach.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-guided trans-hepatic embolization of a renal artery pseudoaneurysm in a patient with acquired solitary kidney and with chronic renal failure secondary to phenacetin abuse

et al. 2014

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A patient with a pseudoaneurysm of the right renal artery underwent treatment with percutaneous approach. No complications were observed. Based on the experience described in this report, a percutaneous ultrasound guided approach can be proposed in selected patients. Renal insufficiency and allergic reactions are potential contraindications to angiography with conventional ionic iodinated contrast dye in patients who need endovascular stent-graft placement. Real-time contrastenhanced ultrasound (CEUS) guided endovascular procedures may provide an alternative to overcome these limitations. We report an endovascular renal artery repair in a solitary kidney patient with an asymptomatic infrarenal aortic aneurysm and renal insufficiency due to phenacetin abuse. The precise placement of the stent-graft was performed with CEUS and intraprocedural angiographic fluoroscopy without the use of any nephrotoxic contrast dye. During follow-up, CEUS was used to exclude endoleaks, stent-graft failure or malposition.Keywords Renal artery pseudoaneurysm Á Chronic renal failure Á Ultrasound Á Coil embolization Á Phenacetine Riassunto Presentiamo il caso di una paziente portatrice di uno pseudoaneurisma dell'arteria renale destra trattato con un approccio percutaneo senza alcuna complicanza. Sulla base dell'esperienza descritta nel presente caso clinico l'approccio percutaneo eco guidato potrebbe essere indicato in pazienti selezionati. La presenza di insufficienza renale e la diatesi allergica rappresentano controindicazioni alla convenzionale manovra angiografica con mezzo di contrasto iodato nei pazienti candidati a manovre di posizionamento endovascolari. Le procedure endovascolari sotto guida ecografica con mezzo di contrasto (CEUS) possono rappresentare una valida alternativa in presenza dei suddetti limiti. Riportiamo il caso di un trattamento endovascolare di uno pseudoaneurisma dell'arteria renale in una paziente con rene unico acquisito destro, affetta inoltre da insufficienza renale cronica da abuso di fenacetina. La manovra di embolizzazione dello pseudoaneurisma, mediante il posizionamento di spirali, è stata eseguita mediante CEUS e angiografia intraprocedurale senza mezzo di contrasto nefrotossico. Durante il follow-up è stata utilizzata la CEUS per escludere endoleaks o malposizionamento delle spirali.Electronic supplementary material The online version of this article

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Duplex-Directed Thrombin Injection as a Method to Treat Femoral Artery Pseudoaneurysms

Cited by 40 publications

References 5 publications

Treatment of Femoral Artery Pseudoaneurysms with Percutaneous Thrombin Injection

Treatment of Femoral Artery Pseudoaneurysms with Percutaneous Thrombin Injection

Ultrasound guided percutaneous thrombin injection of iatrogenic femoral artery pseudoaneurysms after coronary angiography and intervention

Ultrasound-guided trans-hepatic embolization of a renal artery pseudoaneurysm in a patient with acquired solitary kidney and with chronic renal failure secondary to phenacetin abuse

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