Talal ALTUWAİJİRİ, Mussaad ALSALMAN, Abdulamjeed ALTOİJRY, Kaisor IQBAL, Hesham ALGHOFİLİ

Kateterizasyon sonrası femoral arter psödoanevrizmasının tedavisinde ultrason eşliğinde kompresyon onarımına kıyasla ultrason eşliğinde trombin enjeksiyonu: Kral Saud Üniversitesi Tıp Merkezi Deneyimi

Amaç: Bu çalışmada iyatrojenik femoral arter psödoanevrizmalarının tedavisinde ultrason eşliğinde kompresyon onarımına kıyasla ultrason eşliğinde trombin enjeksiyonunun etkinliği değerlendirildi. Çalışma planı: Haziran 2006-Aralık 2015 tarihleri arasında ultrason eşliğinde trombin enjeksiyonu ile tedavi edilen femoral psödoanevrizmalı toplam 29 ardışık hasta (15 erkek, 14 kadın; ort. yaş 54 yıl; dağılım, 26-81 yıl) retrospektif olarak incelendi. Bu hastalar Şubat 1999 - Mayıs 2006 tarihleri arasında ultrason eşliğinde kompresyon onarımı yapılan 36 hastadan oluşan (21 erkek, 15 kadın; ort. yaş 44 yıl; dağılım, 32-65 yıl) bir kronolojik grup ile karşılaştırıldı. Tüm hastaların tıbbi kayıtları ve damar laboratuvar bulguları incelendi. Tedavi başarısı, femoral arterdeki akımın korunarak, akımın yanlış lümene hareketinin tamamen sona ermesi olarak tanımlandı. Bulgular: Ultrason eşliğinde trombin enjeksiyonunun başarı oranı %100 olup, ultrason eşliğinde kompresyon onarımının başarı oranı muhtemelen antikoagülan tedavi, hipertansiyon ve >6 cm’lik anevrizma çapından etkilendiğinden %80.5 idi. Ancak, bu faktörlerin hiçbiri trombin enjeksiyonlarının başarısını etkilemedi. Sonuç: Ultrason eşliğinde trombin enjeksiyonu son derece başarılı, uygulaması kolay, kabul edilebilir ve hastalar tarafından iyi tolere edilen bir yöntemdir. Hipertansiyonu olan, anevrizması büyük olan ve antikoagülan tedavisi alan hastalarda, kompresyon tedavisinden daha etkilidir.

Ultrasound-guided thrombin injection versus ultrasound-guided compression repair in the treatment of post-catheterization femoral artery pseudoaneurysm: King Saud University Medical Center Experience

Background: This study aims to evaluate the effectiveness ofultrasound-guided thrombin injection versus ultrasound-guidedcompression repair in the management of iatrogenic femoralartery pseudoaneurysms.Methods: Between June 2006 and December 2015, a total of 29consecutive patients (15 males, 14 females; mean age 54 years;range 26 to 81 years) with a femoral pseudoaneurysm treatedby ultrasound-guided thrombin injection were retrospectivelyanalyzed. These patients were compared with a historical groupof 36 patients (21 males, 15 females; mean age 44 years; range32 to 65 years) who underwent ultrasound-guided compressionrepair between February 1999 and May 2006. Medical recordsand vascular laboratory findings of all patients were reviewed.Successful treatment was defined as complete cessation of flowinto the false lumen with preservation of flow in the femoral artery.Results: The ultrasound-guided thrombin injection showed asuccess rate of 100%, whereas ultrasound-guided compressionrepair had a success rate of 80.5%, which was possibly affectedby anticoagulant therapy, hypertension, and an aneurysm size of>6 cm. However, none of these factors did not affect the successof thrombin injections.Conclusion: Ultrasound-guided thrombin injection is a highlysuccessful, easy to perform, accepted, and well-tolerated methodby patients. It is more effective compared to compression therapyin patients with hypertension, large aneurysms, and who are onanticoagulant therapy.

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