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超声引导下注射凝血酶治疗导管术后假性动脉瘤及其扩展适应证

Ultrasound-Guided Thrombin Injection for Postcatheterization Pseudoaneurysms and Its Extended Indications.

作者信息

Ozawa Hirotsugu, Ohki Takao, Kaneko Kenjiro, Momose Masamichi, Hirayama Shigeki

机构信息

Vascular Surgery, Shin-yurigaoka General Hospital, Kawasaki, Kanagawa, Japan.

Division of Vascular Surgery, Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan.

出版信息

Ann Vasc Dis. 2022 Mar 25;15(1):22-28. doi: 10.3400/avd.oa.21-00071.

Abstract

Ultrasound-guided thrombin injection (UGTI) is an option for the treatment of postcatheterization pseudoaneurysms. This method is less invasive and less time-consuming compared with other procedures since it can be performed without general anesthesia, skin incision, or occlusion of the artery. Herein, we report on the efficacy of UGTI for postcatheterization bleeding complications. Postcatheterization bleeding complications include postcatheterization pseudoaneurysm and failed hemostasis. In this study, failed hemostasis was defined as cases in which hemostasis could not be accomplished by 30 min of manual compression following sheath removal. A retrospective study of eight cases in which we performed UGTI for postcatheterization bleeding complications between July 2016 and June 2019 at our institution was performed to evaluate technical success and recurrence of pseudoaneurysm or rebleeding events. Among these eight cases, there were three cases of pseudoaneurysm and five cases of failed hemostasis. In all cases, technical success was achieved without any complications such as distal embolism or allergic reaction. There were no recurrences of pseudoaneurysm or rebleeding events during an average follow-up of 5.25 months. We believe that UGTI is effective not only for postcatheterization pseudoaneurysms but also for failed hemostasis.

摘要

超声引导下凝血酶注射(UGTI)是治疗导管插入术后假性动脉瘤的一种选择。与其他手术相比,该方法侵入性较小且耗时较短,因为它无需全身麻醉、皮肤切口或动脉闭塞即可进行。在此,我们报告UGTI治疗导管插入术后出血并发症的疗效。导管插入术后出血并发症包括导管插入术后假性动脉瘤和止血失败。在本研究中,止血失败定义为在拔除鞘管后手动压迫30分钟仍无法实现止血的病例。我们对2016年7月至2019年6月在我们机构对8例导管插入术后出血并发症进行UGTI治疗的病例进行了回顾性研究,以评估技术成功率以及假性动脉瘤或再出血事件的复发情况。在这8例病例中,有3例假性动脉瘤病例和5例止血失败病例。在所有病例中,均实现了技术成功,且未出现任何并发症,如远端栓塞或过敏反应。在平均5.25个月的随访期间,假性动脉瘤或再出血事件均未复发。我们认为UGTI不仅对导管插入术后假性动脉瘤有效,而且对止血失败也有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b414/8958405/5aced5797c0f/avd-15-1-oa.21-00071-figure01.jpg

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