1. Ultrasound-guided compression repair
(UGCR)
- UGCR is a good alternative to surgical repair and has become the primary
method of treatment in many institutions.
- However, the procedure is time-consuming and painful, has poor results
with patients who are undergoing anticoagulation therapy.
- The typical success rate is between 60% and 90%.
Semin Vasc Surg 2000;13:58-61,
J Vasc Surg 1996;23:28-35
2. Surgical repair
- Surgery requires an incision and has a prolonged recovery time, and
wound infections is common.
- In addition, surgical repair is problematic in the patient requiring
ongoing anticoagulation and exposes the patient to the potential risks
of anesthesia.
- Nineteen percent to 32% of patients develop wound-healing disorders
and permanent femoral neuralgias.
Radiology 1995;195:463-466
Am J Surg 1994;167:375-378
- Frequencies of lymphatic leaks are as high as 40%.
J Vasc Tech 2001;25:209-212
3. Ultrasoun-guided thrombin injection (UGTI)
- Even when US-guided compression is initially successful, pseudoaneurysm
recurrence rates are reported as 20% in patients receiving anticoagulation
or antiplatelet theraphy.
- UGTI was safe and effective in 94% of patients with postcatheterization
pseudoaneuryms.
Circulation 2000;102:2391-2395
- The primary success rate was 93.8%. The secondary success rate was 99.6%.
Thromboembolic complications occurred in two patients (0.8%) and resolved
spontaneously. One mild allergic reaction and no infections occurred.
Radiology 2005;236:1104-1110
1. High success rates
2. Low complication rates
3. Ease of performance
4. Short procedure times
5. No radiation exposure
--> US-guided percutaneous injection of thrombin could be regarded
as the theraphy of choice for the management of postcatheterization pseudoaneurysm.
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