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Human Thrombin for Treatment of Pseudoaneurysms: Comparison of Bovine and Human Thrombin Sonogram-Guided Injection

Victoria Vázquez1, Manuel Reus1, Antonio Piñero2, Dolores Abellán3, Manuel Canteras4, Mariano Espinosa de Rueda1, Dolores Morales1 and Pascual Parrilla2

1 Department of Roentgenology, Hospital Universitario Virgen de la Arrixaca, Ctra. Madrid-Cartagena, El Palmar 30120, Murcia, Spain.
2 Department of Surgery, Hospital Universitario Virgen de la Arrixaca, Ctra. Madrid-Murcia, El Palmar, Murcia, Spain.
3 Department of General Practice, Hospital Morales Meseguer, Murcia, Spain.
4 Department of Statistics, University of Murcia, Spain.



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  		Fig. 1. —Schematic illustrates percutaneous injection of thrombin directly into pseudoaneurysm (PSA) lumen. Using free-hand technique, 22-gauge spinal needle is advanced into lumen with one hand and transducer is in other hand. Once needle is in position, thrombin is slowly injected.

 


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  		Fig. 2A. —65-year-old man with simple pseudoaneurysm (PSA) lobe that originates from common femoral artery. Pseudoaneurysm size is 3.5 x 3 cm. Transverse color Doppler sonogram at groin puncture site reveals a pseudoaneurysm with the characteristic to-and-from blood-flow pattern.

 


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  		Fig. 2B. —65-year-old man with simple pseudoaneurysm (PSA) lobe that originates from common femoral artery. Pseudoaneurysm size is 3.5 x 3 cm. Sagittal (longitudinal) color Doppler sonogram shows localization of neck of pseudoaneurysm and native femoral artery.

 


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  		Fig. 2C. —65-year-old man with simple pseudoaneurysm (PSA) lobe that originates from common femoral artery. Pseudoaneurysm size is 3.5 x 3 cm. Transverse sonogram using gray-scale technique shows 22-gauge needle is passed into lumen. Note echogenic needle track.

 


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  		Fig. 2D. —65-year-old man with simple pseudoaneurysm (PSA) lobe that originates from common femoral artery. Pseudoaneurysm size is 3.5 x 3 cm. Transverse color Doppler sonogram after injection of 0.1 mL of human thrombin shows complete occlusion of pseudoaneurysm. Echogenic material (clot) represents fresh thrombus.

 

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