Document Detail

Transcatheter "thrombin-blood patch" injection: A novel and effective approach to treat catheterization-related arterial perforation.
MedLine Citation:
PMID:  23024065     Owner:  NLM     Status:  Publisher    
OBJECTIVE: This study aimed to describe the safety and feasibility of transcatheter "thrombin-blood patch" (TBP) injection to treat catheterization-related arterial vascular access perforation. BACKGROUND: Vascular access complications are infrequent but potentially life threatening conditions related to percutaneous procedures. Surgical vascular repair are associated with high rates of morbidity and mortality due to advanced cardiovascular disease. METHODS: From October 2007 to July 2010 we studied 23 patients who presented active access arterial bleeding after percutaneous procedures and underwent transcatheter angiographic guided TBP injection across the entry site of the arterial perforation as a primary approach. RESULTS: The mean age of the population was 67 years, predominantly female (78.3%) with high rate of comorbidities including diabetes (30.4%), prior coronary revascularization (50.0%), chronic renal failure (43.5%), and heart failure (56.5%). Thirteen patients (56.5%) developed severe hypotension after the index procedure. The repair procedure had a mean duration of 82 ± 57 minutes. TBP was injected in all patients. One case additionally required covered-stent to obtain hemostasis. Angiographic success was achieved in the 23 patients; however, one case required a second intervention due to recurrent bleeding, which was effectively treated using covered-stent. All patients were discharged alive and no major cardiovascular events, including myocardial infarction/stroke, were observed. CONCLUSIONS: Transcatheter "thrombin-blood patch" injection is a safe, novel technique that allows prompt percutaneous approach to treat catheterization-related arterial perforation. This strategy appears particularly attractive to treat patients who cannot tolerate "open" vascular reconstruction and repair. © 2012 Wiley Periodicals, Inc.
Gabriel Maluenda; Lavinia Mitulescu; Itsik Ben-Dor; Gabriel Sardi; Rafael Romaguera; Lowell F Satler; Augusto D Pichard; Ron Waksman; Nelson L Bernardo
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-9-28
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  -     ISSN:  1522-726X     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-10-1     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Wiley Periodicals, Inc.
Division of Cardiology, Department of Internal Medicine, Washington Hospital Center, Washington, District of Columbia.
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