Jacek Kurzawski1, Agnieszka Janion-Sadowska2, Marcin Sadowski3. 1. 1 Second Department of Cardiology, Świętokrzyskie Cardiology Centre , Kielce , Poland. 2. 2 Świętokrzyskie Cardiology Centre, Intensive Cardiac Care Unit , Kielce , Poland. 3. 3 The Jan Kochanowski University, Faculty of Medicne and Health Sciences , Kielce , Poland.
Abstract
OBJECTIVE: To investigate the efficacy and safety of ultrasound-guided tissue glue injection for the treatment of iatrogenic femoral artery pseudoaneurysm. METHODS: The study comprised of nine patients with unsuccessful ultrasound-guided thrombin injection and one patient with rapidly progressing anemia. All patients had undergone recanalization procedures at least twice, including two subjects with a very rapidly enlarging pseudoaneurysm lobe or significant anemia. Tissue glue at a dose of 0.9 ± 0.53 ml was injected under ultrasound guidance in each patient. RESULTS: Complete embolization was achieved in all patients. Follow-up ultrasound performed 24 h later as well as at 1 and 2 weeks did not show recurrent reperfusion of the pseudoaneurysm. CONCLUSION: Embolization of iatrogenic pseudoaneurysm using tissue glue seems to be an effective technique for the treatment of this complication. It might be considered as a treatment option in case of unsuccessful primary repair by means of thrombin injection orhemorrhagic shock due to rapid aneurysm progression. Advances in knowledge: Patients with multiple recanalizations and those with dynamically enlarging pseudoaneurysm or rapidly progressing anemia are at risk of life-threatening bleeding. An ultrasound-guided tissue glue injection, a novel method for the treatment of femoral artery pseudoaneurysm, might be considered as a treatment option especially in case of primary thrombin injection failure.
OBJECTIVE: To investigate the efficacy and safety of ultrasound-guided tissue glue injection for the treatment of iatrogenic femoral artery pseudoaneurysm. METHODS: The study comprised of nine patients with unsuccessful ultrasound-guided thrombin injection and one patient with rapidly progressing anemia. All patients had undergone recanalization procedures at least twice, including two subjects with a very rapidly enlarging pseudoaneurysm lobe or significant anemia. Tissue glue at a dose of 0.9 ± 0.53 ml was injected under ultrasound guidance in each patient. RESULTS: Complete embolization was achieved in all patients. Follow-up ultrasound performed 24 h later as well as at 1 and 2 weeks did not show recurrent reperfusion of the pseudoaneurysm. CONCLUSION: Embolization of iatrogenic pseudoaneurysm using tissue glue seems to be an effective technique for the treatment of this complication. It might be considered as a treatment option in case of unsuccessful primary repair by means of thrombin injection orhemorrhagic shock due to rapid aneurysm progression. Advances in knowledge: Patients with multiple recanalizations and those with dynamically enlarging pseudoaneurysm or rapidly progressing anemia are at risk of life-threatening bleeding. An ultrasound-guided tissue glue injection, a novel method for the treatment of femoral artery pseudoaneurysm, might be considered as a treatment option especially in case of primary thrombin injection failure.
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