Ferguson J D, Whatling P J, Martin V, Walton J, Banning A P
Department of Cardiology, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UK.
Heart. 2001 Apr;85(4):E5. doi: 10.1136/heart.85.4.e5.
Ultrasound guided percutaneous thrombin injection has recently been described for the treatment of iatrogenic femoral pseudoaneurysms. Patient selection and technical aspects of this technique are still evolving and safety data, particularly after coronary intervention, remains limited. The percutaneous thrombin injection of femoral artery pseudoaneurysms in 13 consecutive patients, most of whom were receiving antiplatelet/anticoagulant treatment (aspirin 11, heparin 4, clopidogrel 6), is reported. Thrombin (1000 U/ml) was injected over several seconds until Doppler colour flow within the cavity ceased. The median dose of thrombin injected was 800 U (range 200-1000 U) and the treatment was successful in all cases without complication. In one case, thrombus was visualised within the arterial lumen immediately after thrombin injection, but this dissolved spontaneously within five minutes without evidence of embolisation. In contrast to ultrasound guided compression, percutaneous thrombin injection of femoral pseudoaneurysms is a rapid, well tolerated, and successful technique even in patients receiving antiplatelet/anticoagulant treatment.
最近有文献报道了超声引导下经皮注射凝血酶治疗医源性股动脉假性动脉瘤。该技术的患者选择和技术细节仍在不断发展，其安全性数据，尤其是冠状动脉介入治疗后的安全性数据仍然有限。本文报道了连续13例股动脉假性动脉瘤患者接受经皮注射凝血酶治疗的情况，其中大多数患者正在接受抗血小板/抗凝治疗（阿司匹林11例，肝素4例，氯吡格雷6例）。将凝血酶（1000 U/ml）在数秒内注入，直到腔内多普勒彩色血流停止。注入凝血酶的中位剂量为800 U（范围200 - 1000 U），所有病例治疗均成功且无并发症。有1例患者在注射凝血酶后立即在动脉腔内可见血栓，但该血栓在5分钟内自发溶解，无栓塞迹象。与超声引导下压迫治疗相比，经皮注射凝血酶治疗股动脉假性动脉瘤即使对于接受抗血小板/抗凝治疗的患者也是一种快速、耐受性良好且成功的技术。
