Efficacy Evaluation Of Bio Trombina ® 400 In Mini Mall Y Invasive Treatment of Complications (Pseudoaneurysms), After Venipuncture for Diagnostic Purposes. Authors’ Own Experience – Case Study of 38 Patients

• Authors: Marek Iłżecki , Tomasz Zubilewicz , Stanisław Przywara , Andrzej Wojtak , Jan Jakub Kęsik , Małgorzata Olejniczak-Nowakowska , Piotr Terlecki
• Languages of publication: EN

Abstracts

EN

Common use of venipuncture on upper and lower limbs for diagnostic purposes (such as coronarography or arteriography), and also during the course of treatment (angioplasty), very often bares a complication in the form of pseudoaneurysms. According to various reports, the incidence of pseudoaneurysms ranges from 0.005% to 0.5% of all vascular procedures requiring arterial cannulation (Common Femoral Artery, Brachial Artery, Radial Artery). The use of Bio Trombina® 400 in the embolization of pseudoaneurysms allows minimally invasive and effective treatment. The aim of the study was to evaluate the efficacy of pseudoaneurysm embolization with the use of Trombina 400, authors’ own experience. Material and methods. In the years 2011 - 2013, the authors of this study performed 38 vascular interventional procedures involving pseudoaneurysms as complications of venipuncture in upper and lower limbs for diagnostic and treatment purposes. All procedures involved the direct injection of thrombin into the chamber of the pseudoaneurysm under the guidance of USG Doppler (6.2 MHz linear head). 34 cases presented single chamber pseudoaneurysms while 4 cases involved multi- chamber pseudoaneurysms, which required several thrombin reinjections (Bio Trombina® 400) into each of the chambers. Pseudoaneurysm maximum size of 4 cm was set as an inclusion criterion for the embolization procedure. Furthermore, all pseudoaneurysms with a significantly wide tract in transverse dimensions were treated as an exclusion criterion because of high risk of the peripheral arteries embolization. Results. Initial success was observed in 36 patients (94.73%) in the first day after the procedure, 1 patient (2.63%) underwent thrombin reinjection procedure in the second day after the first embolization. Another patient (2.63%) underwent an open procedure in which the Common Femoral Artery was accessed, the clot evacuated, and CFA was sutured with continuous suture Prolene 6-0. Conclusions. 1. Embolization of pseudoaneurysms with USG Doppler-guided thrombin injection is an effective course of treatment for complications of cannulation. 2. The safety of pseudoaneurysm embolization depends on a surgeon’s experience. It is also crucial to keep in mind the inclusion and exclusion criteria for this type of procedure (the size of a pseudoaneurysm, the width of its base). 3. Furthermore, its cost effectiveness and short hospitalization period make pseudoaneurysm embolization an effective and valuable alternative to the classic approach.

Keywords

EN

embolization; pseudoaneurysm; trombin

• Publisher: De Gruyter Open
• Journal: Polish Journal of Surgery
• Year: 2015
• Volume: 86
• Issue: 8
• Pages: 359-363

Dates

published

1 - 8 - 2014

received

29 - 6 - 2014

online

3 - 10 - 2014

Contributors

author

Marek Iłżecki

• Department of Vascular Surgery and Angiology, Medical University in Lublin

author

Tomasz Zubilewicz

• Department of Vascular Surgery and Angiology, Medical University in Lublin

author

Stanisław Przywara

• Department of Vascular Surgery and Angiology, Medical University in Lublin

author

Andrzej Wojtak

• Department of Vascular Surgery and Angiology, Medical University in Lublin

author

Jan Jakub Kęsik

• Department of Vascular Surgery and Angiology, Medical University in Lublin

author

Małgorzata Olejniczak-Nowakowska

• Department of Public Health, Public Health Unit at the Medical University of Silesia in Katowice

author

Piotr Terlecki

• Department of Vascular Surgery and Angiology, Medical University in Lublin

References

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Identifiers

DOI

10.2478/pjs-2014-0064