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超声引导下经皮注射凝血酶治疗血管通路所致股动脉假性动脉瘤

Ultrasound-Guided Percutaneous Thrombin Injection of Femoral Artery Pseudoaneurysms Caused by Vascular Access.

作者信息

Chae Seung Yoon, Park Chan, Kim Jae Kyu, Kim Hyoung Ook, Lee Byung Chan

出版信息

Taehan Yongsang Uihakhoe Chi. 2021 May;82(3):589-599. doi: 10.3348/jksr.2020.0113. Epub 2021 Mar 22.

Abstract

PURPOSE

To analyze the success and complication rates and factors associated with technical failure of the ultrasound (US)-guided percutaneous thrombin injection of femoral artery pseudoaneurysms caused by vascular access.

MATERIALS AND METHODS

Records of 30 patients with post-catheterization femoral artery pseudoaneurysms who had been treated with US-guided percutaneous thrombin injections in the department of radiology between March 2009 and June 2019 were retrospectively analyzed. The lesion was diagnosed based on US or contrast-enhanced CT. The characteristics of the patients and their lesions were analyzed.

RESULTS

The mean patient age was 67.8 years. The mean diameter of the pseudoaneurysmal sac was 20.88 mm (5-40 mm). Twenty patients (66.6%) obtained complete thrombosis after the primary injection, while 10 patients (33.3%) obtained partial thrombosis. The number of patients with a low platelet count (< 130 k/µL) was significantly higher in the partial thrombosis group than in the complete thrombosis group ( = 0.02). No substantial procedure-related complications were found in any patient.

CONCLUSION

The US-guided percutaneous thrombin injection is considered an initial treatment option for pseudoaneurysms caused by vascular access because of its safety and efficacy.

摘要

目的

分析超声(US)引导下经皮注射凝血酶治疗血管穿刺所致股动脉假性动脉瘤的成功率、并发症发生率及与技术失败相关的因素。

材料与方法

回顾性分析2009年3月至2019年6月间在放射科接受US引导下经皮注射凝血酶治疗的30例导管插入术后股动脉假性动脉瘤患者的记录。根据超声或增强CT诊断病变。分析患者及其病变的特征。

结果

患者平均年龄为67.8岁。假性动脉瘤囊的平均直径为20.88mm(5 - 40mm)。20例患者(66.6%)在首次注射后实现完全血栓形成,而10例患者(33.3%)实现部分血栓形成。部分血栓形成组血小板计数低(<130k/µL)的患者数量显著高于完全血栓形成组(P = 0.02)。未在任何患者中发现与操作相关的严重并发症。

结论

由于其安全性和有效性,US引导下经皮注射凝血酶被认为是血管穿刺所致假性动脉瘤的初始治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c35/9432433/977a114e6314/jksr-82-589-g001.jpg

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