Jargiełło Tomasz, Sobstyl Jan, Światłowski Łukasz, Kuczyńska Maryla, Kuklik Ewa, Sojka Michał, Drelich-Zbroja Anna, Pech Maciej, Powerski Maciej
Department of Interventional Radiology and Neuroradiology, Medical University of Lublin, Lublin, Poland.
Department of Radiology and Nuclear Medicine, Otto von Guericke University, Magdeburg, Germany.
J Ultrason. 2018;18(73):85-89. doi: 10.15557/JoU.2018.0012.
The purpose of this paper was to evaluate the efficacy of ultrasound-guided percutaneous thrombin injection as a treatment method for arterial access site pseudoaneurysm.
A total of 148 patients with iatrogenic arterial access site pseudoaneurysms were treated in the Department of Interventional Radiology and Neuroradiology, Medical University of Lublin. Of those, 142 pseudoaneurysms were located in the common femoral artery, 3 in the brachial artery and the remaining 3 in the radial artery. The study included 77 woman and 71 men (mean age 64.5 ± 14 years). Patients were qualified for percutaneous thrombin injection after Doppler examination during which pseudoaneurysm size and morphology were assessed as well as the presence of arteriovenous fistula was excluded.
In the reported study, 94.8% (128/135) of patients were successfully treated during the initial thrombin injection. Additional 400 IU dose of thrombin after 24 hours was effective in 5 out of 7 patients with recanalization during the follow-up. A total of 98.5% (133/135) of patients were successfully treated with a percutaneous ultrasound-guided thrombin injection.
The 10-year experience presented in this study as well as literature reports prove that percutaneous ultrasound-guided thrombin injection is an effective and safe treatment method for iatrogenic arterial access site pseudoaneurysm.
本文旨在评估超声引导下经皮注射凝血酶治疗动脉穿刺部位假性动脉瘤的疗效。
卢布林医科大学介入放射科和神经放射科共治疗了148例医源性动脉穿刺部位假性动脉瘤患者。其中，142例假性动脉瘤位于股总动脉，3例位于肱动脉，其余3例位于桡动脉。研究包括77名女性和71名男性（平均年龄64.5±14岁）。患者在多普勒检查后符合经皮注射凝血酶的条件，在此期间评估假性动脉瘤的大小和形态，并排除动静脉瘘的存在。
在本研究中，94.8%（128/135）的患者在首次注射凝血酶时成功治愈。24小时后追加400 IU凝血酶对7例随访期间再通的患者中的5例有效。共有98.5%（133/135）的患者通过超声引导下经皮注射凝血酶成功治愈。
本研究中呈现的10年经验以及文献报道证明，超声引导下经皮注射凝血酶是治疗医源性动脉穿刺部位假性动脉瘤的一种有效且安全的治疗方法。
