Postangiographic femoral artery injuries: nonsurgical repair with US-guided compression.

Fellmeth, Brian D.; Roberts, Anne C.; Bookstein, Joseph J.; Freischlag, Julie A.; Forsythe, John R.; Buckner, Nancy K.; Hye, Robert J.

doi:10.1148/radiology.178.3.1994400

Cited by 417 publications

(240 citation statements)

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“…In patients on oral anticoagulants, however, there was a positive correlation between the length of the aneurysmatic tract and the success of UGCR: In 24 patients on oral anticoagulants, a communicating channel between the extraluminal cavity and the femoral artery could be detected by duplex scanning; in 2 pseudoaneurysms, the extraluminal cavity was located so close to the femoral artery that no communicating channel could be detected. UGCR was successfully performed on 1 week after anticoagulant therapy was ended, 2 were closed by percutaneous implantation of collagen plugs, and 2 were treated surgically. One patient died of renal failure (6 days after the last follow-up duplex scan), and another patient was discharged with arrangements for clinical follow-up of the pseudoaneurysm (Fig 1).…”

Section: False Aneurysmsmentioning

confidence: 99%

New aspects in ultrasound-guided compression repair of postcatheterization femoral artery injuries.

et al. 1994

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Background This study was undertaken to expand the understanding of ultrasound-guided compression repair (UGCR) of postcatheterization femoral artery injuries.Methods and Results In a series of 62 patients with pseudoaneurysms (n=53) or arteriovenous (AV) fistulas (n=9), UGCR was performed as a nonsurgical method in the treatment of postcatheterization femoral artery injuries. When the communicating channel could be visualized (43 cases), pressure was focused on it; otherwise (10 cases) the extraluminal cavity itself was compressed. In 45 cases, the elimination of flow in the pseudoaneurysm and/or the communicating channel could be achieved only with simultaneous temporary complete occlusion of the femoral artery. UGCR was success-

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Section: False Aneurysmsmentioning

confidence: 99%

New aspects in ultrasound-guided compression repair of postcatheterization femoral artery injuries.

et al. 1994

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“…Surgery requires prolonged recovery time and exposes the patient to several complications, such as bleeding, lymphocele and infections, without mentioning the risks of anesthesia. As a result of advances in ultrasonographic imaging, in 1991 US guided pseudoaneurysm compression was introduced [5] and surgical repair was almost abandoned. This procedure has a low rate of complications, but as a drawback, it is not well tolerated by the patient and sedation or intravenous analgesia is required.…”

Section: Discussionmentioning

confidence: 99%

“…[5]. We report the case of an alternative renal artery pseudoaneurysm treatment with percutaneous trans-hepatic ultrasound (US) guided coil embolization in a patient with a story of phenacetin abuse and prone to pseudoaneurysm development.…”

Section: Introductionmentioning

confidence: 99%

Ultrasound-guided trans-hepatic embolization of a renal artery pseudoaneurysm in a patient with acquired solitary kidney and with chronic renal failure secondary to phenacetin abuse

et al. 2014

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A patient with a pseudoaneurysm of the right renal artery underwent treatment with percutaneous approach. No complications were observed. Based on the experience described in this report, a percutaneous ultrasound guided approach can be proposed in selected patients. Renal insufficiency and allergic reactions are potential contraindications to angiography with conventional ionic iodinated contrast dye in patients who need endovascular stent-graft placement. Real-time contrastenhanced ultrasound (CEUS) guided endovascular procedures may provide an alternative to overcome these limitations. We report an endovascular renal artery repair in a solitary kidney patient with an asymptomatic infrarenal aortic aneurysm and renal insufficiency due to phenacetin abuse. The precise placement of the stent-graft was performed with CEUS and intraprocedural angiographic fluoroscopy without the use of any nephrotoxic contrast dye. During follow-up, CEUS was used to exclude endoleaks, stent-graft failure or malposition.Keywords Renal artery pseudoaneurysm Á Chronic renal failure Á Ultrasound Á Coil embolization Á Phenacetine Riassunto Presentiamo il caso di una paziente portatrice di uno pseudoaneurisma dell'arteria renale destra trattato con un approccio percutaneo senza alcuna complicanza. Sulla base dell'esperienza descritta nel presente caso clinico l'approccio percutaneo eco guidato potrebbe essere indicato in pazienti selezionati. La presenza di insufficienza renale e la diatesi allergica rappresentano controindicazioni alla convenzionale manovra angiografica con mezzo di contrasto iodato nei pazienti candidati a manovre di posizionamento endovascolari. Le procedure endovascolari sotto guida ecografica con mezzo di contrasto (CEUS) possono rappresentare una valida alternativa in presenza dei suddetti limiti. Riportiamo il caso di un trattamento endovascolare di uno pseudoaneurisma dell'arteria renale in una paziente con rene unico acquisito destro, affetta inoltre da insufficienza renale cronica da abuso di fenacetina. La manovra di embolizzazione dello pseudoaneurisma, mediante il posizionamento di spirali, è stata eseguita mediante CEUS e angiografia intraprocedurale senza mezzo di contrasto nefrotossico. Durante il follow-up è stata utilizzata la CEUS per escludere endoleaks o malposizionamento delle spirali.Electronic supplementary material The online version of this article

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“…Small pseudoaneurysms, especially those with diameters smaller than 2.0 cm, can be treated conservatively and spontaneous thrombosis can be expected 16,17 . Compression guided by ultrasound is a treatment that has variable results and success rates of 50 to 95% and also causes patients discomfort 18 . of these components injected is greater than when thrombin alone is used.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous treatment of femoral pseudoaneurysms: comparison of fibrin sealant against thrombin

Pinto

Bastianetto

2013

J. vasc. bras.

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Introduction: Femoral pseudoaneurysms are a complication that occurs in connection with up to 8% of percutaneous procedures. Of the available treatments, ultrasound guided thrombin injection has a high success rate and is welltolerated by patients. The combination of thrombin and fibrinogen known as fibrin sealant forms a stable clot and can be used to treat pseudoaneurysms, particularly those with complex anatomy and larger size. Objective: To compare the results of treating femoral pseudoaneurysm in two ways: Group T was treated with thrombin alone and Group T+F was treated with fibrin sealant (thrombin+fibrinogen). Methods: A retrospective analysis was conducted of femoral pseudoaneurysm cases treated between January 2005 and December 2012. Results: Twenty-eight patients were treated, 21 with thrombin alone and seven with fibrin sealant. All patients in group T were treated successfully, but only four patients in group T+F were treated successfully (57.1% success rate in Group T+F, p<0.01). The three cases of failure in group T+F needed surgery and in one of these cases the complication was embolization to the femoral bifurcation. The pseudoaneurysms that were treated with fibrin sealant were larger (25 cm 3 in Group T and 57.7 cm 3 in Group T+F, p=0.02) and required larger volumes of thrombin (0.5 mL in Group T and 1.0 mL in Group T+F, p<0.01). There was one complication in Group T and two complications in Group T+F (p<0.01). Conclusions: Irrespective of the small number of cases reviewed, treatment with thrombin alone was superior to treating with fibrin sealant, since it caused few complications and was more effective at correcting pseudoaneurysms.

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Postangiographic femoral artery injuries: nonsurgical repair with US-guided compression.

Cited by 417 publications

References 0 publications

New aspects in ultrasound-guided compression repair of postcatheterization femoral artery injuries.

New aspects in ultrasound-guided compression repair of postcatheterization femoral artery injuries.

Ultrasound-guided trans-hepatic embolization of a renal artery pseudoaneurysm in a patient with acquired solitary kidney and with chronic renal failure secondary to phenacetin abuse

Percutaneous treatment of femoral pseudoaneurysms: comparison of fibrin sealant against thrombin

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