Treatment of radial and ulnar artery pseudoaneurysms using percutaneous thrombin injection

Komorowska-Timek, Ewa; Teruya, Theodore H.; Abou-Zamzam, Ahmed M.; Papa, Diane; Ballard, Jeffrey L.

doi:10.1016/j.jhsa.2004.05.009

Cited by 56 publications

(43 citation statements)

References 27 publications

(52 reference statements)

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“…[16][17][18][19] An ultrasound-guided thrombin injection has also been reported as valid alternative therapy for pseudoaneurysms arising more proximally. 20 Recent data shows that the palmar digital artery should be repaired in a pedicular section of the finger, to significantly improve the sensitive recovery quality and cold intolerance of the fingers. 21 Partially devascularized fingers suffer a similar form of cold intolerance, though to a lesser degree.…”

Section: Discussionmentioning

confidence: 99%

False aneurysm of the common digital artery. Is reconstruction with an arterial graft worth the efforts? A case report

et al. 2011

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False aneurysms in the hand are rare. A false aneurysm of the common digital artery in the palm for the second and third finger is reported, illustrating our experience with arterial graft reconstruction after excision as a valid alternative surgical therapy to a vein graft, when ligation or end-to-end anastomosis are not indicated or feasible. The superficial palmar branch of the radial artery was chosen as donor vessel based on the similarity in vessel diameter and wall thickness to the common digital arteries. Ease of harvesting and performing the microvascular anastomosis using an arterial graft allows for a viable reconstruction after false aneurysm excision in the palm.

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Section: Discussionmentioning

confidence: 99%

False aneurysm of the common digital artery. Is reconstruction with an arterial graft worth the efforts? A case report

et al. 2011

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“…US is also used in the treatment of pseudoaneurysms. Specifically, US-guided compression or thrombin injection has been shown to be effective in the treatment of peripheral pseudoaneurysms (33)(34)(35).…”

Section: Vesselsmentioning

confidence: 99%

US findings in traumatic wrist and hand injuries

Karabay

2012

Diagn Interv Radiol

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Traumatic injuries of the wrist and hand are common. Ultrasonography (US) is a cost-effective, noninvasive, and effective imaging method for diagnosing traumatic lesions affecting the tendons, annular pulleys, ligaments, vessels, and nerves, and for detecting foreign bodies in the wrist and hand. The objective of this article was to review the main US findings of traumatic lesions in the wrist and hand.T he wrist and hand are the most important functional parts of the body in daily life activities and are prone to traumatic injuries. These injuries constitute 6.6% to 28.6% of all injuries and 28.0% of all musculoskeletal injuries (1, 2). According to Schoffl et al. (3), wrist and hand injuries account for 14.0% to 30.0% of all treated patients in emergency care. Although these injuries are not life-threatening, the accepted treatment strategy for traumatic injuries is immediate reconstruction of all injured tissue structures. Hence, early diagnosis of the injured tissue is important for clinical management.Current ultrasonography (US) systems equipped with linear-array transducers have improved the capability of US to examine superficial organs and tissues. As an easily accessible, rapid, noninvasive imaging technique that also provides dynamic examination, US is a good imaging modality for examining the musculoskeletal system (4, 5).The purpose of this article was to review the main US findings and discuss the potential value of this technique in the evaluation of traumatic injuries of the wrist and hand. US techniquesUsing proper US examination techniques based on a thorough knowledge of the relevant anatomy and artifacts is essential for accurate diagnosis. High-frequency linear-array transducers (7-15 MHz) are mandatory for the ultrasonographic evaluation of superficial structures. The wrist and hand are best examined with the patient seated in front of the examiner with the wrist and hand placed on a table. The transducer is held with the first three fingers, and the other fingers rest on the table to reduce contact pressure. The longitudinal axis is the principal axis and is essential for diagnosis, while the transverse images are used for support. A large amount of transmission jelly is required for good contact and near field resolution.

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“…In this case, however, a second injection was required to achieve complete occlusion. Subsequently a 2.5-cm ulnar artery pseudoaneurysm was successfully injected without compromise of the ulnar artery itself in a study by Komorowska-Timek et al [15]. The Journal of Ultrasound Medicine in a study of thrombin injection into pseudoaneurysms in unusual sites also reported thrombosis of an iatrogenic pseudoaneurysm of the anterior tibial artery after osteotomy of the fibula with percutaneous thrombin injection under ultrasound guidance [16].…”

Section: Peripheral Vessel Pseudoaneurysmsmentioning

confidence: 99%

The use of thrombin in the radiology department

et al. 2008

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Thrombin is a naturally occurring coagulation protein that converts soluble fibrinogen into insoluble fibrin and plays a vital role in the coagulation cascade and in turn haemostasis. Thrombin also promotes platelet activation. In the last few years, there has been a rapid increase in the use of thrombin by radiologists in a variety of clinical circumstances. It is best known for its use in the treatment of pseudoaneurysms following angiography. However, there are now a variety of cases in the literature describing the treatment of traumatic, inflammatory and infected aneurysms with thrombin in a variety of locations within the human body. There have even been recent reports describing the use of thrombin in conventional aneurysms as well as ruptured aneurysms. Its use has also been described in the treatment of endoleaks (type II) following aneurysm repair. In nearly all of these cases, treatment with thrombin requires imaging guidance. Recently, thrombin has also been used as a topical treatment post-percutaneous intervention to reduce or stop bleeding. Most radiologists have only a limited knowledge of the pharmacodynamics of thrombin, its wide range of utilisation and its limitations. Apart from a few case reports and case series, there is little in the radiological literature encompassing the wide range of applications that thrombin may have in the radiology department. In this review article, we comprehensively describe the role and pathophysiology of thrombin, describing with examples many of its potential uses. Techniques of usage as well as pitfalls and limitations are also described.

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Treatment of radial and ulnar artery pseudoaneurysms using percutaneous thrombin injection

Cited by 56 publications

References 27 publications

False aneurysm of the common digital artery. Is reconstruction with an arterial graft worth the efforts? A case report

False aneurysm of the common digital artery. Is reconstruction with an arterial graft worth the efforts? A case report

US findings in traumatic wrist and hand injuries

The use of thrombin in the radiology department

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