Treatment of iatrogenic femoral pseudoaneurysms with thrombin injection--results in 54 patients

To evaluate ultrasound-guided percutaneous thrombin injection to treat iatrogenic femoral pseudoaneurysms following catheter interventions. In a period of 2 years and 11 months, 55 iatrogenic femoral pseudoaneurysms were treated in 54 patients (male : female = 29 : 25) by percutaneous thrombin injection under continuous color Doppler control. Mean maximum diameter of the perfused lumen was 2.5 cm (SD +/- 1 cm). The injected thrombin doses varied between 10 and 2,000 U (median 200 U). Following thrombin injection, the pseudoaneurysm occlusion rate was 100 % (n = 55/55). Complete and persistent occlusion was achieved in 54 of 55 (98 %) pseudoaneurysms. A repeated procedure was necessary in 6 pseudoaneurysms. In one case (2 %), discrete signs of reperfusion were observed after primary occlusion within 24 hours of the initial procedure (lumen diameter 3 x 5 mm), followed by spontaneous thrombosis without further treatment. No complications, in particular no clinically manifest thromboembolic events, were observed. Ultrasound-guided percutaneous thrombin injection is an effective and safe method for the treatment of iatrogenic post catheterization femoral pseudoaneurysms.