Doppler ultrasound-guided percutaneous thrombin injection for treating femoral pseudoaneurysms

Objective: To evaluate the success rate of percutaneous injectionof thrombin, guided by Doppler ultrasound to treat femoralpseudoaneurysms. Methods: Twenty-three patients withfemoral pseudoaneurysms were treated with ultrasound-guidedthrombin injection, between September 2003 and October 2007.Pseudoaneurysm size, dose of thrombin used, result of therapy andcomplications were prospectively documented. Other aspects analyzedincluded the type of procedure that caused the pseudoaneurysm(diagnostic catheterization, angioplasty, stent placement), size ofendovascular introducer, use of hemostatic device and body massindex (BMI) of patients. Results: A total of 27 injections of thrombinwere performed. The mean transverse diameter was 3.5 cm. Themean dose of thrombin injected was 666.7 IU. The primary successrate ranged from 19 to 23 (83%). Reperfusion occurred in onepseudoaneurysm. The rate of secondary thrombosis was four in four(100%). No thromboembolic, infectious or allergic complicationsoccurred. Conclusions: Ultrasound-guided percutaneous thrombininjection is the best method for treating femoral pseudoaneurysmscaused by endovascular procedures. It presents high rates of success,low recurrence rates and almost no complications.