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Development of Nonobstructive Intraarterial Thrombi After Injection of Thrombin into Pseudoaneurysms

Anil K. Dasyam1,2, William D. Middleton1 and Sharlene A. Teefey1

1 Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd., St. Louis, MO 63110-1076.
2 Present address: Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, PA.


Figure 1
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  		Fig. 1A —Patient 1, 53-year-old man with ischemic heart disease. P = pseudoaneurysm, A = common femoral artery. Transverse color Doppler image 3 days after cardiac catheterization shows small pseudoaneurysm anterior to common femoral artery.

 

Figure 2
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  		Fig. 1B —Patient 1, 53-year-old man with ischemic heart disease. P = pseudoaneurysm, A = common femoral artery. Transverse color Doppler image after injection of 200 units of thrombin shows no residual flow in lumen of pseudoaneurysm.

 

Figure 3
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  		Fig. 1C —Patient 1, 53-year-old man with ischemic heart disease. P = pseudoaneurysm, A = common femoral artery. Longitudinal gray-scale image obtained immediately after injection of thrombin shows nonocclusive thrombus (arrow) in common femoral artery.

 

Figure 4
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  		Fig. 2A —Patient 3, 72-year-old woman, with spindle cell neoplasm of sacrum. P = pseudoaneurysm, A = common femoral artery. Color Doppler image and pulsed Doppler waveform 1 day after tumor embolization shows small pseudoaneurysm arising from common femoral artery. Typical to-and-fro waveform is documented in pseudoaneurysm neck.

 

Figure 5
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  		Fig. 2B —Patient 3, 72-year-old woman, with spindle cell neoplasm of sacrum. P = pseudoaneurysm, A = common femoral artery. Longitudinal gray-scale image obtained immediately after injection of 50 units of thrombin shows nonocclusive thrombus (arrow) in lumen of artery.

 

Figure 6
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  		Fig. 2C —Patient 3, 72-year-old woman, with spindle cell neoplasm of sacrum. P = pseudoaneurysm, A = common femoral artery. Longitudinal gray-scale image taken 1 day after injection of thrombin shows residual thrombus (arrow) that has decreased slightly in size.

 

Figure 7
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  		Fig. 2D —Patient 3, 72-year-old woman, with spindle cell neoplasm of sacrum. P = pseudoaneurysm, A = common femoral artery. Longitudinal gray-scale image obtained 3 weeks after injection of thrombin shows resolution of intraarterial thrombus and resolution of pseudoaneurysm.

 

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