Efficacy and safety of a coagulated thrombus injection for peripheral artery perforation: The coagulated thrombus hemostasis method

Abstract

Thrombus injection is a safety method and might be considered as one of the approaches for stopping peripheral artery perforation.

Thoracoacromial artery bleeding manifests as an enlarging chest mass: A rare case report

“…However, if still active bleeding in damaged vessel, we could do low-pressure balloon tamponade, [4] percutaneous stenting with a graft stent, [5] coil embolization of the ruptured vessel if it could be sacrified, [6] or coagulated thrombus injection for artery perforation. [7] Balloon occlusion in the treatment of coronary perforation was widely used in coronary perforation. The methods based on the duration and completeness of the occlusion, including persistent complete occlusion, persistent partial occlusion, intermittent complete occlusion and intermittent partial occlusion.…”

“…As previous study, 19 of the 20 perforations (95%) was successfully treated by this method and only one patient need coil embolization. [7] We should also consider protamine to partially reverse the effect of heparin, and discontinue the possible medication which would lead to coagulopathy, such as antiplatelet agents or anticoagulant. However, in this case, we stopped the bleeding in few hours after using sandbag and elastic adhesive tape to compress the enlarging hematoma, we did not discontinue antiplatelet agents in the next day.…”

An alternative treatment strategy for large vessel coronary perforations

“…Subsequent treatment depends on the type of perforation. Large vessel perforations are usually treated with covered stents, whereas distal vessel or collateral vessel perforation is usually treated with fat or coil or occasionally thrombus embolization . Covered stent delivery can, however, be challenging due to high crossing profile and low flexibility, especially through tortuous and calcified vessels, which are more prone to development of perforations.…”

Perforations and how to manage: The coronary interventionalist and peripheral interventionalist working together for a solution

“…This cross fertilization can be very helpful for coronary and peripheral interventionists alike. We salute Tokuda et al in this relatively large single center retrospective experience using a simple, safe, and effective technique.…”

“…This is neither applicable nor appropriate in all coronary or peripheral perforation cases because of vessel size, or importance of critical side branches (such as the deep femoral artery). In the retrospective study described, the endovascular treatment (EVT) perforation occurred in a side branch or at chronic total occlusion (CTO) site which lends itself to the relatively permanent use of coagulated blood and thrombin . The operators were skillful and in some cases, were able to treat with ballooning, but in many cases they combined the use of our technique we described using autologous blood combined with thrombin .…”