Percutaneous Thrombin Injection for the Treatment of Post-Procedural Iatrogenic Pseudoaneurysms

Purpose To report our clinical experience of thrombin injection for iatrogenic pseudoaneurysms of peripheral arteries with or without balloon dilatation and coil embolization as adjunctive techniques. Materials and Methods A total of 10 patients undergoing thrombin injection for iatrogenic pseudoaneurysms from September 2007 to June 2017 were retrospectively investigated. The causative procedures, location of pseudoaneurysms, and complications were recorded, and technical and clinical success rates of the treatment were assessed. Results The femoral and brachial arteries were treated in eight and two patients, respectively. Technical success was confirmed in all cases, and a clinical success rate was 70% (7/10) was noted. Two patients presented with a complication of acute thrombosis at the distal arteries. In 7 patients, balloon occlusion was performed before injection of thrombin to prevent the spread of thrombin. Coil embolization of the distal branch was also performed in one of these patients. Conclusion For pseudoaneurysms of the femoral and brachial arteries that develop after various vascular procedures, thrombin injection is a safe and efficient treatment choice. In some cases, where there is concern for thrombin leakage, balloon occlusion and coil embolization could be performed together.