Karsten Krueger MD, Presenter: Nothing to Disclose

David Strohe, Abstract Co-Author: Nothing to Disclose

Markus Zaehringer, Abstract Co-Author: Nothing to Disclose

Klaus Lackner, Abstract Co-Author: Nothing to Disclose

To determine the success and complication rate of percutaneous ultrasound-guided thrombin injection in the treatment of femoral and brachial pseudoaneurysms

204 patients with postcatheter femoral (n=199) or brachial (n=5) pseudoaneurysms were treated with ultrasound-guided percutaneous thrombin injections. Pseudoaneurysm size, length and width of neck, thrombin dose, outcome of therapy and complications were prospectively documented. Duplex sonographic follow-up's were performed after 12-24 h, 5-7 days and 21-25 days.

The mean volume of pseudoaneurysms was 4.40ą4.46 cmł. A total of 222 thrombin injections were performed (maximum 4 per patient). The mean thrombin dose was 428ą376 IU (min 50 IU, max 2300 IU). There was no correlation between the thrombin dose and size of aneurysm (r=0.25). Primary success rate was 95.8% for simple (1 lobe) and 86.6% for complex pseudoaneurysms (>1 lobe). Secondary success rate was 99.5% (100% for simple, 98.3% for complex pseudoaneurysms). One patient was operated. Thrombembolic complications occurred in 2 patients (0.98%) and resolved spontaneously. One slight allergic reaction was observed. Early reperfusion (< 24h) occurred in 1 simple and five complex pseudoaneurysms. Three late reperfusions (2 in simple, 1 in complex pseudoaneurysms) were detected at one week follow-up (none at three weeks). At one week follow-up 39.2 % of patients complained about groin pain (6.8 % at 3 weeks).

Ultrasound-guided percutaneous injection of thrombin is successful and safe in the management of postcatheter pseudoaneurysms. Duplex sonographic follow-up is necessary to detect early or late reperfusion.

Krueger, K, Strohe, D, Zaehringer, M, Lackner, K, The Postcatheter Pseudoaneurysm: Results after 204 Patients Treated with Ultrasound-guided Percutaneous Thrombin Injection.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4404719.html Accessed May 13, 2025