Balloon-Assisted Ultrasound-Guided Percutaneous Thrombin Injection of Iatrogenic Femoral Artery Pseudoaneurysms: A Case Report and Description of the Technique

Travis J. Vowels, M. Mujeeb Zubair, Jean Bismuth, Linda Le

Research output: Contribution to journalArticle

Abstract

Ultrasound-guided thrombin injection (UGTI) has emerged as the first-line treatment for moderately sized or persistent pseudoaneurysms (PSAs). Although rare, the most feared complication of UGTI is arterial thrombosis or embolism during the off-label injection of thrombin causing acute limb ischemia requiring emergent surgical intervention. Higher thrombin volume, rapidity of injection, and wide or short-neck PSAs are all thought to increase the risk of arterial thrombosis or embolism during this procedure. For patients with unfavorable PSA anatomy who are high-risk surgical candidates due to their medical comorbidities or active critical illness, balloon-assisted thrombin injection (BATI) has been suggested as a means to potentially reduce the risk of thrombosis or distal embolization associated with UGTI. This minimally invasive technique also decreases the risk of groin wound dehiscence or infection associated with open repair, especially in patients who are morbidly obese or have had prior groin surgery. We report a patient with a complex femoral artery PSA after endovascular intervention who was successfully treated with BATI and describe the procedure in detail.

Original languageEnglish (US)
Pages (from-to)532-535
Number of pages4
JournalVascular and Endovascular Surgery
Volume54
Issue number6
DOIs
StatePublished - Aug 1 2020

Keywords

  • balloon-assisted
  • iatrogenic
  • pseudoaneurysm
  • thrombin injection
  • ultrasound-guided

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

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