Document Detail


Minimally invasive therapy of pseudoaneurysms of the trunk: application of thrombin.
MedLine Citation:
PMID:  18196334     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Thrombin injection has been proven to be successful in postcatheterization pseudoaneurysms. However, there are only a few reports on the treatment of pseudoaneurysms of the trunk. We report our first experiences using a percutaneous as well as an endovascular access. Eight iatrogenic pseudoaneurysms of the trunk (aorta, n = 4; pulmonary artery, n = 1; gastroduodenal artery, n = 1; left gastric artery, n = 1, renal artery, n = 1) were treated either percutaneously using CT guidance (n = 3) or via an endovascular access (n = 5). Noninvasive control angiograms were performed at day 1 and weeks 1 and 3 by either CT or MR angiography. The total volume of the pseudoaneurysms was 31.2 +/- 23.1 ml on average, with a mean volume of the perfused aneurysmal lumen of 12.9 +/- 7.2 ml. The maximum diameter was 4.1 +/- 1.39 cm on average. In each case, the aneurysmal neck was not wider than 2 mm. One pseudoaneurysm occluded spontaneously following selective catheterization. The remaining pseudoaneurysms were successfully treated by injection of 765 +/- 438.1 IU thrombin. In one individual, a nontarget embolization occurred, as well as an intervention-associated rupture of a pseudoaneurysm. High-grade stenoses of the donor artery were found in a different case. Only once was the endoluminal access converted to a percutaneous one. Thrombin injection might be a future first-line treatment of vascular lesions such as pseudoaneurysms of the trunk. In our experience both percutanous and endoluminal access are technically feasible and safe. However, further experiences are mandatory, especially concerning the question of dosage and long-term results.
Authors:
Frank Schellhammer; Daniele Steinhaus; Mathias Cohnen; Jonas Hoppe; Ulrich Mödder; Günter Fürst
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Publication Detail:
Type:  Journal Article     Date:  2008-01-15
Journal Detail:
Title:  Cardiovascular and interventional radiology     Volume:  31     ISSN:  1432-086X     ISO Abbreviation:  Cardiovasc Intervent Radiol     Publication Date:    2008 May-Jun
Date Detail:
Created Date:  2008-05-06     Completed Date:  2008-07-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8003538     Medline TA:  Cardiovasc Intervent Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  535-41     Citation Subset:  IM    
Affiliation:
Department of Diagnostic Radiology, University Hospital, Moorenstr. 5, D-40225 Duesseldorf, Germany. frank.schellhammer@med.uni-duesseldorf.de
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aneurysm, False / etiology,  radiography*,  therapy*
Angiography / methods
Aorta, Abdominal
Aorta, Thoracic
Catheterization / adverse effects*,  methods
Dose-Response Relationship, Drug
Female
Follow-Up Studies
Humans
Iatrogenic Disease*
Injections, Intralesional
Injections, Subcutaneous
Male
Middle Aged
Pulmonary Artery
Renal Artery
Risk Assessment
Thrombin / administration & dosage*
Tomography, Spiral Computed
Treatment Outcome
Chemical
Reg. No./Substance:
EC 3.4.21.5/Thrombin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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