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
Journal Title: Polish Journal of Surgery - Year 2014, Vol 86, Issue 8
Abstract
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.
Authors and Affiliations
Marek Iłżecki, Tomasz Zubilewicz, Stanisław Przywara, Andrzej Wojtak, Jan Jakub Kęsik, Małgorzata Olejniczak-Nowakowska, Piotr Terlecki
Keywords
Related Articles
- EP ID EP74427
- DOI 10.2478/pjs-2014-0064
- Views 113
- Downloads 0
Treatment possibilities of reverse-flow sural flap in covering the defects of lower extremities
Soft tissue defects of the lower extremity pose an important surgical challenge, often because of inviability of primary covering. Therapeutic modalities of choice comprise of local perforator flaps, as well as of free f...
Dokumentacja fotograficzna w praktyce chirurga plastyka
Celem pracy była analiza zarządzania kliniczną dokumentacją fotograficzną wśród chirurgów plastycznych w Polsce oraz uzyskanie ich opinii na temat charakterystyki „idealnego” oprogramowania do archiwizacji zdjęć. Materia...
Evaluation of Endostatin and EGF Serum Levels in Patients with Gastric Cancer
<br/><b>The aim of the study</b> was to assess angiogenesis markers – endostatin and endothelial growth factor (EGF) as markers of detection of gastric carcinoma. <br/><b>Material and methods.</b> The study involved 20...
Inguinal pain syndrome. The influence of intraoperative local administration of 0.5% bupivacaine on postoperative pain control following Lichtenstein hernioplasty. A prospective case-control study.
With current technological advancement and availability of synthetic materials used in inguinal hernia repair, a recurrence after first intervention is not a common and important adverse event. On the other hand, however...
Gastroenterocolic fistula in the patient after previous gastric resection and hepaticoenterostomy due to complicated ulcer disease – case report
The report presents the case of a patient treated surgically for perforated gastroenterocolic fistula with a concomitant abscess in abdominal integuments and symptoms of the digestive tract blockage. Many months before t...