Authors contribution: Miguel Borges Santos, MD, manuscript preparation, data analysis, Sergio Silva, MD, study concept and design, review of manuscript, Vitor Bettencourt, MD, study concept and design, Rui Campante Teles, MD, review of manuscript, Manuel Sousa Almeida, MD, study concept and design, review of manuscript, Duarte Medeiros, MD, study concept and design, final version approval, Jose Aniceto Silva, MD, review of manuscript, final version approval
Coronary Artery Disease
Ultrasound-guided thrombin–gelatin injection is effective for the treatment of iatrogenic femoral artery pseudoaneurysms: Initial results
Article first published online: 31 JUL 2012
Copyright © 2012 Wiley Periodicals, Inc.
Catheterization and Cardiovascular Interventions
Volume 81, Issue 2, pages 303–307, February 2013
How to Cite
Santos, M. B., Silva, S., Bettencourt, V., Teles, R. C., Almeida, M. S., Medeiros, D. and Silva, J. A. (2013), Ultrasound-guided thrombin–gelatin injection is effective for the treatment of iatrogenic femoral artery pseudoaneurysms: Initial results. Cathet. Cardiovasc. Intervent., 81: 303–307. doi: 10.1002/ccd.24330
Conflict of interest: Nothing to report.
- Issue published online: 19 FEB 2013
- Article first published online: 31 JUL 2012
- Manuscript Accepted: 7 JAN 2012
- Manuscript Received: 15 MAR 2011
- gelatin sponge;
To describe the technique of ultrasound (US)-guided percutaneous thrombin–gelatin injection for the treatment of femoral artery pseudoaneurysms (FAPs).
FAPs are a possible complication from percutaneous angiographic procedures. US-guided thrombin injection is currently the preferential therapeutic option, limited by a low risk of potentially catastrophic femoral thrombosis; transluminal injection of collagen is another effective and safe option, although a more invasive one; surgical repair is associated with significant comorbidity. We hypothesized that US-guided combined thrombin and gelatin injection (UG-TGI) would also be effective while minimizing the risk of limb thrombosis.
Review of the results, complications and length of hospital admission after the injection into the FAP sac of combined human-origin thrombin and bovine-origin gelatin matrix (FloSeal®, Baxter), under direct US-guidance.
We treated 13 patients (mean age 64 ± 9.46 years, 38% male), who developed a FAP following a percutaneous procedure: isolated coronariography in five (38%); angioplasty in four (31%); other cardiac procedures in four (31%). Immediate success was obtained in all (100%) patients, assessed by US; no allergic reactions, local infection, or embolic events occurred on 30-day follow-up. Median (interquartile range) admission time after the UG-TGI was 2 days (1.25–2.0); median time of total admission was 8 days (6.5–16.25).
In this small study, UG-TGI for the treatment of FAP was feasible and had short-term effectiveness, without a learning curve effect. Despite the need for further experience, a trial comparing different therapies for FAP should include this procedure. © 2012 Wiley Periodicals, Inc.