Paulson E K, Sheafor D H, Kliewer M A, Nelson R C, Eisenberg L B, Sebastian M W, Sketch M H
Department of Radiology, Duke University Medical Center, Box 3808, Erwin Rd, Durham, NC 27710, USA.
Radiology. 2000 May;215(2):403-8. doi: 10.1148/radiology.215.2.r00ap35403.
To evaluate and compare the treatment of iatrogenic femoral arterial pseudoaneurysms by using ultrasonographically (US) guided direct thrombin injection with US-guided compression repair.
Twenty-six patients with iatrogenic femoral arterial pseudoaneurysms were treated with direct thrombin injection. With US guidance, a 22-gauge needle was placed into the pseudoaneurysm flow lumen and thrombin (mean volume, 0.35 mL; range, 0.10-0.60 mL) was injected with continuous color Doppler US guidance. Demographics, clinical variables, pseudoaneurysm characteristics, and results in these patients were compared with those in 281 consecutive patients who underwent US-guided compression repair.
The success rate of thrombin injection was 96% (25 of 26 patients), which was significantly higher than that of compression, 74% (209 of 281 patients) (P =.013). Twenty of 26 (77%) patients required a single injection, and six (23%) required two injections. Mean thrombosis time for thrombin injection was 6 seconds, compared with 41.5 minutes for compression. For thrombin injection, there were no complications, foot pulses did not change and no patients required conscious sedation. Follow-up US at 24 hours showed no recurrent pseudoaneurysms.
For the treatment of iatrogenic femoral arterial pseudoaneurysms, thrombin injection with US guidance appears to be superior to compression repair.
评估并比较超声引导下直接注射凝血酶与超声引导下压迫修复治疗医源性股动脉假性动脉瘤的效果。
26例医源性股动脉假性动脉瘤患者接受了直接注射凝血酶治疗。在超声引导下，将一根22号针置入假性动脉瘤血流腔，在彩色多普勒超声持续引导下注射凝血酶（平均剂量0.35 mL；范围0.10 - 0.60 mL）。将这些患者的人口统计学资料、临床变量、假性动脉瘤特征及治疗结果与281例连续接受超声引导下压迫修复的患者进行比较。
凝血酶注射的成功率为96%（26例患者中的25例），显著高于压迫修复的成功率74%（281例患者中的209例）（P = 0.013）。26例患者中有20例（77%）仅需单次注射，6例（23%）需要两次注射。凝血酶注射的平均血栓形成时间为6秒，而压迫修复为41.5分钟。凝血酶注射无并发症，足部脉搏未改变，且无需患者清醒镇静。24小时后的随访超声显示无假性动脉瘤复发。
对于医源性股动脉假性动脉瘤的治疗，超声引导下注射凝血酶似乎优于压迫修复。
