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Endoscopic ultrasound-guided thrombin injection, a management approach for visceral artery pseudoaneurysms

Background and study aims  Pseudoaneurysms are usually associated with high rates of morbidity and mortality. There are limited data in the literature on endoscopic ultrasound (EUS)-guided thrombin injection for pseudoaneurysms. The aim of this study is to assess the efficacy and safety of EUS-guide...

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Autores principales: Maharshi, Sudhir, Sharma, Shyam Sunder, Sharma, Deepak, Sapra, Bharat, Nijhawan, Sandeep
Formato: Online Artículo Texto
Lenguaje:English
Publicado: © Georg Thieme Verlag KG 2020
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7035033/
https://www.ncbi.nlm.nih.gov/pubmed/32118114
http://dx.doi.org/10.1055/a-1070-9168
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author Maharshi, Sudhir
Sharma, Shyam Sunder
Sharma, Deepak
Sapra, Bharat
Nijhawan, Sandeep
author_facet Maharshi, Sudhir
Sharma, Shyam Sunder
Sharma, Deepak
Sapra, Bharat
Nijhawan, Sandeep
author_sort Maharshi, Sudhir
collection PubMed
description Background and study aims  Pseudoaneurysms are usually associated with high rates of morbidity and mortality. There are limited data in the literature on endoscopic ultrasound (EUS)-guided thrombin injection for pseudoaneurysms. The aim of this study is to assess the efficacy and safety of EUS-guided thrombin injection for pseudoaneurysms. Patients and methods  This prospective study was conducted in our department between January and December 2018. All patients with symptomatic visceral artery pseudoaneurysms, who were unable to undergo angioembolization, were enrolled consecutively. Data related to demography, laboratory parameters, radiological imaging, pseudoaneurysms, and endotherapy were analyzed. Results  Eight patients with median age 34 years (27–58 years), all men, were studied. The vessel involved was the splenic artery in 5 patients (62.5 %), the left hepatic artery in 2 (25 %), and the gastroduodenal artery in 1 patient (12.5%). The median size of the pseudoaneurysms was 2.9 cm × 2.6 cm (range, 1.8 × 1.9–4 × 5 cm). The median thrombin requirement was 400 IU (range, 200–500 IU) for loss of Doppler flow signals. EUS after 3 months showed obliterated pseudoaneurysms in 7 patients (87.5 %), while recurrence was observed in 1 patient (12.5 %) after 6 weeks. Conclusions  EUS-guided thrombin injection may be a new option for the management of pseudoaneurysms.
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spelling pubmed-70350332020-03-01 Endoscopic ultrasound-guided thrombin injection, a management approach for visceral artery pseudoaneurysms Maharshi, Sudhir Sharma, Shyam Sunder Sharma, Deepak Sapra, Bharat Nijhawan, Sandeep Endosc Int Open Background and study aims  Pseudoaneurysms are usually associated with high rates of morbidity and mortality. There are limited data in the literature on endoscopic ultrasound (EUS)-guided thrombin injection for pseudoaneurysms. The aim of this study is to assess the efficacy and safety of EUS-guided thrombin injection for pseudoaneurysms. Patients and methods  This prospective study was conducted in our department between January and December 2018. All patients with symptomatic visceral artery pseudoaneurysms, who were unable to undergo angioembolization, were enrolled consecutively. Data related to demography, laboratory parameters, radiological imaging, pseudoaneurysms, and endotherapy were analyzed. Results  Eight patients with median age 34 years (27–58 years), all men, were studied. The vessel involved was the splenic artery in 5 patients (62.5 %), the left hepatic artery in 2 (25 %), and the gastroduodenal artery in 1 patient (12.5%). The median size of the pseudoaneurysms was 2.9 cm × 2.6 cm (range, 1.8 × 1.9–4 × 5 cm). The median thrombin requirement was 400 IU (range, 200–500 IU) for loss of Doppler flow signals. EUS after 3 months showed obliterated pseudoaneurysms in 7 patients (87.5 %), while recurrence was observed in 1 patient (12.5 %) after 6 weeks. Conclusions  EUS-guided thrombin injection may be a new option for the management of pseudoaneurysms. © Georg Thieme Verlag KG 2020-03 2020-02-21 /pmc/articles/PMC7035033/ /pubmed/32118114 http://dx.doi.org/10.1055/a-1070-9168 Text en https://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.
spellingShingle Maharshi, Sudhir
Sharma, Shyam Sunder
Sharma, Deepak
Sapra, Bharat
Nijhawan, Sandeep
Endoscopic ultrasound-guided thrombin injection, a management approach for visceral artery pseudoaneurysms
title Endoscopic ultrasound-guided thrombin injection, a management approach for visceral artery pseudoaneurysms
title_full Endoscopic ultrasound-guided thrombin injection, a management approach for visceral artery pseudoaneurysms
title_fullStr Endoscopic ultrasound-guided thrombin injection, a management approach for visceral artery pseudoaneurysms
title_full_unstemmed Endoscopic ultrasound-guided thrombin injection, a management approach for visceral artery pseudoaneurysms
title_short Endoscopic ultrasound-guided thrombin injection, a management approach for visceral artery pseudoaneurysms
title_sort endoscopic ultrasound-guided thrombin injection, a management approach for visceral artery pseudoaneurysms
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7035033/
https://www.ncbi.nlm.nih.gov/pubmed/32118114
http://dx.doi.org/10.1055/a-1070-9168
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