BACKGROUND: Iatrogenic pseudoaneurysm is observed in 0.5% to 2% of diagnostic percutaneous procedures and in up to 7% to 8% of therapeutic percutaneous procedures. Pseudoaneurysm occlusion by ultrasound-guided thrombin injection directly in the aneurysm sac is a minimally invasive, quick and safe procedure with a high success rate. The aim of our study is to report our initial experience in treatment of iatrogenic pseudoaneurysms by ultrasound-guided thrombin injection METHOD: Between September 2006 and February 2010, 1,811 percutaneous coronary interventions were carried out with an occurrence of 15 pseudoaneurysms (0.8%), of which 13 were consecutively treated by ultrasound-guided thrombin injection. Clinical characteristics, type of percutaneous procedure, adjuvant therapy, size and morphology of pseudoaneurysms, thrombin dose, success and complication rate were prospectively documented and later retrospectively analyzed RESULTS: Primary success rate was 100% with just one recurrence seven days after the initial approach, which was successfully treated using the same technique. There were no complications related to the ultrasound-guided thrombin injection and all of the patients were asymptomatic 30 days after the procedure CONCLUSION: Ultrasound-guided thrombin injection performed by professionals experienced in intravascular ultrasound and transparietal punctures of cysts and collections is a feasible, practical and safe option in the treatment of iatrogenic pseudoaneurysms.
Thrombin; Heart catheterization; Ultrasonograpy, interventional
