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Ultrasound-guided thrombin injection for treatment of iatrogenic femoral artery pseudoaneurysms compared with open surgery: first experiences from a single institution

PURPOSE: The frequency of iatrogenic femoral artery pseudoaneurysm (FAP) diagnoses has recently increased due to the growing use of diagnostic and interventional procedures involving large diameter sheaths, as well as more potent anticoagulation procedures. In this study, we aimed to present our exp...

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Autores principales: Saydam, Onur, Serefli, Deniz, Engin, A. Yaprak, Atay, Mehmet
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Surgical Society 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7200607/
https://www.ncbi.nlm.nih.gov/pubmed/32411632
http://dx.doi.org/10.4174/astr.2020.98.5.270
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author Saydam, Onur
Serefli, Deniz
Engin, A. Yaprak
Atay, Mehmet
author_facet Saydam, Onur
Serefli, Deniz
Engin, A. Yaprak
Atay, Mehmet
author_sort Saydam, Onur
collection PubMed
description PURPOSE: The frequency of iatrogenic femoral artery pseudoaneurysm (FAP) diagnoses has recently increased due to the growing use of diagnostic and interventional procedures involving large diameter sheaths, as well as more potent anticoagulation procedures. In this study, we aimed to present our experience with ultrasound-guided thrombin injection (UGTI) in patients with iatrogenic FAP. METHODS: We studied patients with FAP who were under anticoagulant or antiplatelet therapies preoperatively, or who had received a loading dose during an interventional procedure. The outcomes of patients with FAP treated with UGTI were compared with those of patients who underwent open surgical repair for pseudoaneurysms. RESULTS: Among the 55 patients included in this study, 24 had UGTI while 31 had open surgery. The success rate was 95.8% when taking into consideration primary and secondary attempts. The mean duration of the procedure was shorter in patients with UGTI (10.1 ± 3.54 minutes) when compared with those who underwent open surgery (76.55 ± 26.74 minutes, P ≤ 0.001). In addition, the total complication frequency was significantly higher in the open surgery group (P = 0.005), as was their length of hospital stay (P < 0.001). Cost analysis showed significant differences between UGTI ($227.50 ± $82.90) and open surgery ($471.20 ± $437.60, P = 0.01). CONCLUSION: We have found that UGTI is the safer and more effective choice of treatment in appropriate patients with FAP, as opposed to surgery.
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spelling pubmed-72006072020-05-14 Ultrasound-guided thrombin injection for treatment of iatrogenic femoral artery pseudoaneurysms compared with open surgery: first experiences from a single institution Saydam, Onur Serefli, Deniz Engin, A. Yaprak Atay, Mehmet Ann Surg Treat Res Original Article PURPOSE: The frequency of iatrogenic femoral artery pseudoaneurysm (FAP) diagnoses has recently increased due to the growing use of diagnostic and interventional procedures involving large diameter sheaths, as well as more potent anticoagulation procedures. In this study, we aimed to present our experience with ultrasound-guided thrombin injection (UGTI) in patients with iatrogenic FAP. METHODS: We studied patients with FAP who were under anticoagulant or antiplatelet therapies preoperatively, or who had received a loading dose during an interventional procedure. The outcomes of patients with FAP treated with UGTI were compared with those of patients who underwent open surgical repair for pseudoaneurysms. RESULTS: Among the 55 patients included in this study, 24 had UGTI while 31 had open surgery. The success rate was 95.8% when taking into consideration primary and secondary attempts. The mean duration of the procedure was shorter in patients with UGTI (10.1 ± 3.54 minutes) when compared with those who underwent open surgery (76.55 ± 26.74 minutes, P ≤ 0.001). In addition, the total complication frequency was significantly higher in the open surgery group (P = 0.005), as was their length of hospital stay (P < 0.001). Cost analysis showed significant differences between UGTI ($227.50 ± $82.90) and open surgery ($471.20 ± $437.60, P = 0.01). CONCLUSION: We have found that UGTI is the safer and more effective choice of treatment in appropriate patients with FAP, as opposed to surgery. The Korean Surgical Society 2020-05 2020-04-28 /pmc/articles/PMC7200607/ /pubmed/32411632 http://dx.doi.org/10.4174/astr.2020.98.5.270 Text en Copyright © 2020, the Korean Surgical Society http://creativecommons.org/licenses/by-nc/4.0/ Annals of Surgical Treatment and Research is an Open Access Journal. All articles are distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Saydam, Onur
Serefli, Deniz
Engin, A. Yaprak
Atay, Mehmet
Ultrasound-guided thrombin injection for treatment of iatrogenic femoral artery pseudoaneurysms compared with open surgery: first experiences from a single institution
title Ultrasound-guided thrombin injection for treatment of iatrogenic femoral artery pseudoaneurysms compared with open surgery: first experiences from a single institution
title_full Ultrasound-guided thrombin injection for treatment of iatrogenic femoral artery pseudoaneurysms compared with open surgery: first experiences from a single institution
title_fullStr Ultrasound-guided thrombin injection for treatment of iatrogenic femoral artery pseudoaneurysms compared with open surgery: first experiences from a single institution
title_full_unstemmed Ultrasound-guided thrombin injection for treatment of iatrogenic femoral artery pseudoaneurysms compared with open surgery: first experiences from a single institution
title_short Ultrasound-guided thrombin injection for treatment of iatrogenic femoral artery pseudoaneurysms compared with open surgery: first experiences from a single institution
title_sort ultrasound-guided thrombin injection for treatment of iatrogenic femoral artery pseudoaneurysms compared with open surgery: first experiences from a single institution
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7200607/
https://www.ncbi.nlm.nih.gov/pubmed/32411632
http://dx.doi.org/10.4174/astr.2020.98.5.270
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