Browse > Article
http://dx.doi.org/10.3904/kjm.2014.86.4.484

Percutaneous Thrombin Injection with Balloon Occlusion for the Treatment of a Femoral Artery Pseudoaneurysm  

Kim, Byung Sihk (Departments of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine)
Shin, Jeong Hun (Departments of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine)
Kim, You Shin (Departments of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine)
Lee, Yonggu (Departments of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine)
Kim, Jinoo (Departments of Radiology, Hanyang University Guri Hospital, Hanyang University College of Medicine)
Park, Hwan-Cheol (Departments of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine)
Choi, Sung-Il (Departments of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine)
Publication Information
The Korean Journal of Medicine / v.86, no.4, 2014 , pp. 484-488 More about this Journal
Abstract
Femoral artery pseudoaneurysm (FAP) is an uncommon but potentially serious vascular complication that may develop after cardiac and peripheral angiographic procedures. Here we describe the case of a 75-year-old female who presented with a life-threatening bleeding episode due to an FAP 4 days after diagnostic coronary angiography, which was treated with a percutaneous thrombin injection and transient balloon occlusion of the femoral artery during thrombin injection. This case reminds us of the importance of close observation and proper evaluation for complications, even if the risk of bleeding complications is low. Furthermore, although ultrasound-guided compression and a percutaneous thrombin injection are the standard treatment for FAP, this case demonstrates that transient balloon dilation during the percutaneous injection of thrombin is an important treatment option in cases of a wide-necked pseudoaneurysm in which the risk of thrombin escape is high.
Keywords
Femoral artery; Pseudoaneurysm; Thrombin;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Fellmeth BD, Roberts AC, Bookstein JJ, et al. Postangiographic femoral artery injuries: nonsurgical repair with US-guided compression. Radiology 1991;178:671-675.   DOI
2 Katzenschlager R, Ugurluoglu A, Ahmadi A, et al. Incidence of pseudoaneurysm after diagnostic and therapeutic angiography. Radiology 1995;195:463-466.   DOI
3 Webber GW, Jang J, Gustavson S, Olin JW. Contemporary management of postcatheterization pseudoaneurysms. Circulation 2007;115:2666-2674.   DOI   ScienceOn
4 Middleton WD, Dasyam A, Teefey SA. Diagnosis and treatment of iatrogenic femoral artery pseudoaneurysms. Ultrasound Q 2005;21:3-17.
5 Mittleider D, Cicuto K, Dykes T. Percutaneous thrombin injection of a femoral artery pseudoaneurysm with simultaneous venous balloon occlusion of a communicating arteriovenous fistula. Cardiovasc Intervent Radiol 2008;31(Suppl 2):S115-119.   DOI
6 Eisenberg L, Paulson EK, Kliewer MA, Hudson MP, DeLong DM, Carroll BA. Sonographically guided compression repair of pseudoaneurysms: further experience from a single institution. AJR Am J Roentgenol 1999;173:1567-1573.   DOI   ScienceOn
7 Brophy DP, Sheiman RG, Amatulle P, Akbari CM. Iatrogenic femoral pseudoaneurysms: thrombin injection after failed US-guided compression. Radiology 2000;214:278-282.   DOI   ScienceOn
8 Lumsden AB, Miller JM, Kosinski AS, et al. A prospective evaluation of surgically treated groin complications following percutaneous cardiac procedures. Am Surg 1994;60:132-137.
9 Ricci MA, Trevisani GT, Pilcher DB. Vascular complications of cardiac catheterization. Am J Surg 1994;167:375-378.   DOI   ScienceOn