Modified method for intratumoral injection of thrombin for the treatment of iatrogenic pseudoaneurysms_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LIU Qingwen ¹ ,  LIU Xiping ¹ , GUO Yun ¹ , WU Chunmiao ¹ , CUI Peng ¹ , ZHOU Hong ² , LIU Ying ²

1. Department of Interventional Radiology, The Third People’s Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University, Chengdu 610031, P. R. China;
2. Department of Ultrasound, The Third People’s Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University, Chengdu 610031, P. R. China;

Corresponding?author：

LIU Xiping, Email: cdsyyjrlxp@sina.com

Keywords：

iatrogenic pseudoaneurysm; intratumoral injection of thrombin; ultrasound-guide; DSA-mediated

DOI：

10.7507/1007-9424.201905039

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Objective To explore the value of modified method for intratumoral injection of thrombin in the treatment of iatrogenic pseudoaneurysms.Methods Clinical data of 28 patients with iatrogenic pseudoaneurysms after interventional treatment in our hospital from October 2012 to June 2018 were retrospectively analyzed. Twenty-one cases were treated with ultrasound-guided thrombin injection for pseudoaneurysms (Ultrasound group), and seven cases were treated with DSA-mediated balloon occlusion and thrombin injection for pseudoaneurysms (DSA group). The patients were followed-up at 1 day, 1 month and 3 monthS after operation.Results The total success rates of the two groups were 100%. There was no treatment-related complications in the two groups. There was no recurrence after 1–3 months of treatment.Conclusions Intratumoral injection of thrombin can be used for the treatment of iatrogenic pseudoaneurysm. The effect of the improved treatment is more significant. These two methods can be used as the best way to treat iatrogenic pseudoaneurysm with different neck diameters.

Citation： LIU Qingwen, LIU Xiping, GUO Yun, WU Chunmiao, CUI Peng, ZHOU Hong, LIU Ying. Modified method for intratumoral injection of thrombin for the treatment of iatrogenic pseudoaneurysms. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2019, 26(10): 1205-1208. doi: 10.7507/1007-9424.201905039 Copy

1.	Webber GW, Jang J, Gustavson S, et al. Contemporary mana-gement of postcatheterization pseudoaneurysms. Circulation, 2007, 115(20): 2666-2674.
2.	Vlachou PA, Karkos CD, Bains S, et al. Percutaneous ultrasound-guided thrombin injection for the treatment of iatrogenic femoral artery pseudoaneurysms. Eur J Radiol, 2011, 77(1): 172-174.
3.	Righini M, Quéré I, Laroehe JP. Treatment of postcatheterization femoral false aneurysms. J Mal Vasc, 2004, 29(2): 63-72.
4.	Corso R, Rampoldi A, Riolo F, et al. Occlusion of post-catheterisation femoral pseudoaneurysms with percutaneous thrombin injection under ultrasound guidance. Radiol Med, 2004, 108(4): 385-393.
5.	藍春勇, 王小燕. 彩色多普勒超聲在醫源性假性動脈瘤診治中的應用研究概況. 中國臨床新醫學, 2016, 9(6): 541-543.
6.	Fellmeth BD, Roberts AC, Bookstein JJ, et al. Postangiographic femoral artery injuries: nonsurgical repair with US-guided compression. Radiology, 1991, 178(3): 671-675.
7.	Eisenberg L, Paulson EK, Kliewer MA, et al. Sonographically guided compression repair of pseudoaneurysms: further experience from a single institution. AJR Am J Roentgenol, 1999, 173(6): 1567-1573.
8.	Schaub F, Theiss W, Busch R. Management of 219 consecutive cases of postcatheterization pseudoaneurysm. J Am Coll Cardiol, 1997, 30(3): 670-675.
9.	Ates M, Sahin S, Konuralp C, et al. Evaluation of risk factors associated with femoral pseudoaneurysms after cardiac catheterization. J Vasc Surg, 2006, 43(3): 520-524.
10.	崔國明, 侯家聲. 股動脈假性動脈瘤彩色多普勒超聲診斷及監測分析. 醫學影像學雜志, 2009, 19(12): 1598-1600.
11.	Liau CS, Ho FM, Chen MF, et al. Treatment of iatrogenic femoral artery pseudoaneurysm with percutaneous thrombin injection. J Vasc Surg, 1997, 26(1): 18-23.
12.	Sackett WR, Taylor SM, Coffey CB, et al. Ultrasound-guided thrombin injection of iatrogenic femoral pseudoaneurysms: a prospective analysis. Am Surg, 2000, 66(10): 937-942.
13.	Calton WC Jr, Franklin DP, Elmore JR, et al. Ultrasound-guided thrombin injection is a safe and durable treatment for femoral pseudoaneurysms. Vasc Surg, 2001, 35(5): 379-383.
14.	Olsen DM, Rodriguez JA, Vranic M, et al. A prospective study of ultrasound scan-guided thrombin injection of femoral pseudoaneurysm: a trend toward minimal medication. J Vasc Surg, 2002, 36(4): 779-782.
15.	Schneider C, Malisius R, Küchler R, et al. A prospective study on ultrasound-guided percutaneous thrombin injection for treatment of iatrogenic post-catheterisation femoral pseudoaneurysms. Int J Cardiol, 2009, 131, 131(3): 356-361.
16.	Kleczynski P, Rakowski T, Dziewierz A, et al. Ultrasound-guided thrombin injection in the treatment of iatrogenic arterial pseudoaneurysms: single-center experience. J Clin Ultrasound, 2014, 42(1): 24-26.
17.	Stone PA, Aburahma AF, Flaherty SK, et al. Femoral pseudo-aneurysms. Vasc Endovascular Surg, 2006, 40(2): 109-117.
18.	胡正明, 孫德勝, 魯樹坤, 等. 改良法超聲引導下注射凝血酶治療股動脈假性動脈瘤. 中國醫學影像學雜志, 2011, 19(6): 455-457.
19.	景紅霞, 鄭光美, 白姣, 等. 超聲引導下 2 種方法瘤腔內注射凝血酶治療股動脈假性動脈瘤效果觀察. 中華實用診斷與治療雜志, 2013, 27(12): 1203-1204.
20.	程志剛, 韓治宇, 劉方義, 等. 彩色多普勒血流顯像引導近瘤頸部收縮期分次注射小劑量凝血酶溶液治療股動脈假性動脈瘤的效果. 中國醫藥導報, 2017, 14(4): 82-85.
21.	鐘銳, 劉曉琳, 林勇, 等. 改良法超聲引導下分次注射小劑量凝血酶治療股動脈假性動脈瘤的應用價值. 中國血管外科雜志(電子版), 2018, 10(1): 46-49.
22.	Pezzullo JA, Dupuy DE, Cronan JJ. Percutaneous injection of thrombin for the treatment of pseudoaneurysms after catheterization: an alternative to sonographically guided compression. AJR Am J Roentgenol, 2000, 175(4): 1035-1040.
23.	Rahellino M, Zander T, Baldi S, et al. Clinical follow-up in endovascular treatment for TASC C-D lesions in femoral popliteal segment. Catheter Cardiovasc Inter, 2009, 73(5): 701-705.
24.	Golchehr B, Kruse R, van Walraven LA, et al. Three-year outcome of the heparin-bonded Viabahn for superficial femoral artery occlusive disease. J Vase Surg, 2015, 62(4): 984-989.
25.	Latic A, Delibegovic M, Pudic I, et al. Non-invasive ultrasound guided compression repair of post puncture femoral pseudoaneurysm. Med Arh, 2011, 65(2): 113-114.

1. Webber GW, Jang J, Gustavson S, et al. Contemporary mana-gement of postcatheterization pseudoaneurysms. Circulation, 2007, 115(20): 2666-2674.
2. Vlachou PA, Karkos CD, Bains S, et al. Percutaneous ultrasound-guided thrombin injection for the treatment of iatrogenic femoral artery pseudoaneurysms. Eur J Radiol, 2011, 77(1): 172-174.
3. Righini M, Quéré I, Laroehe JP. Treatment of postcatheterization femoral false aneurysms. J Mal Vasc, 2004, 29(2): 63-72.
4. Corso R, Rampoldi A, Riolo F, et al. Occlusion of post-catheterisation femoral pseudoaneurysms with percutaneous thrombin injection under ultrasound guidance. Radiol Med, 2004, 108(4): 385-393.
5. 藍春勇, 王小燕. 彩色多普勒超聲在醫源性假性動脈瘤診治中的應用研究概況. 中國臨床新醫學, 2016, 9(6): 541-543.
6. Fellmeth BD, Roberts AC, Bookstein JJ, et al. Postangiographic femoral artery injuries: nonsurgical repair with US-guided compression. Radiology, 1991, 178(3): 671-675.
7. Eisenberg L, Paulson EK, Kliewer MA, et al. Sonographically guided compression repair of pseudoaneurysms: further experience from a single institution. AJR Am J Roentgenol, 1999, 173(6): 1567-1573.
8. Schaub F, Theiss W, Busch R. Management of 219 consecutive cases of postcatheterization pseudoaneurysm. J Am Coll Cardiol, 1997, 30(3): 670-675.
9. Ates M, Sahin S, Konuralp C, et al. Evaluation of risk factors associated with femoral pseudoaneurysms after cardiac catheterization. J Vasc Surg, 2006, 43(3): 520-524.
10. 崔國明, 侯家聲. 股動脈假性動脈瘤彩色多普勒超聲診斷及監測分析. 醫學影像學雜志, 2009, 19(12): 1598-1600.
11. Liau CS, Ho FM, Chen MF, et al. Treatment of iatrogenic femoral artery pseudoaneurysm with percutaneous thrombin injection. J Vasc Surg, 1997, 26(1): 18-23.
12. Sackett WR, Taylor SM, Coffey CB, et al. Ultrasound-guided thrombin injection of iatrogenic femoral pseudoaneurysms: a prospective analysis. Am Surg, 2000, 66(10): 937-942.
13. Calton WC Jr, Franklin DP, Elmore JR, et al. Ultrasound-guided thrombin injection is a safe and durable treatment for femoral pseudoaneurysms. Vasc Surg, 2001, 35(5): 379-383.
14. Olsen DM, Rodriguez JA, Vranic M, et al. A prospective study of ultrasound scan-guided thrombin injection of femoral pseudoaneurysm: a trend toward minimal medication. J Vasc Surg, 2002, 36(4): 779-782.
15. Schneider C, Malisius R, Küchler R, et al. A prospective study on ultrasound-guided percutaneous thrombin injection for treatment of iatrogenic post-catheterisation femoral pseudoaneurysms. Int J Cardiol, 2009, 131, 131(3): 356-361.
16. Kleczynski P, Rakowski T, Dziewierz A, et al. Ultrasound-guided thrombin injection in the treatment of iatrogenic arterial pseudoaneurysms: single-center experience. J Clin Ultrasound, 2014, 42(1): 24-26.
17. Stone PA, Aburahma AF, Flaherty SK, et al. Femoral pseudo-aneurysms. Vasc Endovascular Surg, 2006, 40(2): 109-117.
18. 胡正明, 孫德勝, 魯樹坤, 等. 改良法超聲引導下注射凝血酶治療股動脈假性動脈瘤. 中國醫學影像學雜志, 2011, 19(6): 455-457.
19. 景紅霞, 鄭光美, 白姣, 等. 超聲引導下 2 種方法瘤腔內注射凝血酶治療股動脈假性動脈瘤效果觀察. 中華實用診斷與治療雜志, 2013, 27(12): 1203-1204.
20. 程志剛, 韓治宇, 劉方義, 等. 彩色多普勒血流顯像引導近瘤頸部收縮期分次注射小劑量凝血酶溶液治療股動脈假性動脈瘤的效果. 中國醫藥導報, 2017, 14(4): 82-85.
21. 鐘銳, 劉曉琳, 林勇, 等. 改良法超聲引導下分次注射小劑量凝血酶治療股動脈假性動脈瘤的應用價值. 中國血管外科雜志(電子版), 2018, 10(1): 46-49.
22. Pezzullo JA, Dupuy DE, Cronan JJ. Percutaneous injection of thrombin for the treatment of pseudoaneurysms after catheterization: an alternative to sonographically guided compression. AJR Am J Roentgenol, 2000, 175(4): 1035-1040.
23. Rahellino M, Zander T, Baldi S, et al. Clinical follow-up in endovascular treatment for TASC C-D lesions in femoral popliteal segment. Catheter Cardiovasc Inter, 2009, 73(5): 701-705.
24. Golchehr B, Kruse R, van Walraven LA, et al. Three-year outcome of the heparin-bonded Viabahn for superficial femoral artery occlusive disease. J Vase Surg, 2015, 62(4): 984-989.
25. Latic A, Delibegovic M, Pudic I, et al. Non-invasive ultrasound guided compression repair of post puncture femoral pseudoaneurysm. Med Arh, 2011, 65(2): 113-114.

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Modified method for intratumoral injection of thrombin for the treatment of iatrogenic pseudoaneurysms

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