Sánchez EMA, Nuño EC, Llamas MFJ, Ramos LCR, Herrera FHT, Martínez MC, Ponce de León GO, Pérez DMA, Castillo ZM, Fernández CE

Language: Spanish
References: 12
Page: 13-18
PDF size: 102.82 Kb.

ABSTRACT

Objective: To demonstrate the effectiveness of the eco-guided human thrombin injection in occlusion of iatrogenic arterial pseudoaneurism, security of application and percentage of closing.
Material and Methods: Design: Series of cases. They studied 12 adult patients (8 females, 4 males) age average 63 years, carriers of arterial pseudoaneurism of iatrogenic etiology demonstrated by clinic and ultrasound, diameters of 1.5 to 6 cm and with a smaller neck of 5mm. Patients with cutaneous infection in site excluded themselves from injury, well-known allergy to thrombin. With aseptic technique, duplex was located to the pseudoaneurism with eco Doppler, was realized eco-guided puncture and needle (22G) with key of 3 routes of the cavity with the gray scale was introduced in center, for direct vision. Solution became congested slowly, human Thrombin (Tissucol^® Baxter) concentration 1000 UI/mL with active Doppler function color to confirm the thrombosis of the coat and to assure right volumetric capacity. Was considered success when disappearance of flow with integrity of pulses and flows. It was placed a compressive bandage 24 hrs and one stayed to the patient in rest in bed during 6 hrs; the pursuit to the 7 and 30 days with Doppler ultrasound duplex and clinical evaluation.
Results: Age mediates 63 years of the patients of who 33% are masculine and feminine 67%. Within the excellent factors of risk were arterial hypertension (83%), diabetes (50%); 50% of the patients had antiaggregation or anticoagulation and obesity in 66%. All the pseudonaeurismas in femoral artery (left reason 2:1 right/) had practiced procedure to endovascular of therapeutic type in 66% of the patients. The so large average 48 mm x 44 mm, the diameter of communication average of 2.8 mm and the volume administered average of thrombin was 2.28 mL, the diameter of the Introducer oscillate between 5 and 7 F. Adverse complications or deaths or effects did not appear. All the controls reported arterial integrity with complete occlusion to the 30 days.
Conclusions: The eco-guided human thrombin injection is an effective, fast, safe technique, better tolerated by the patient and with a smaller consumption of hospitable resources, reason why in our center we at the moment considered the technique of first election in the treatment of the iatrogenic pseudoaneurisms.

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