The Korean Journal of Medicine

  • 제86권4호
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  • Pages.484-488
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  • 2014
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  • 1738-9364(pISSN)
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  • 2289-0769(eISSN)
대한내과학회 (The Korean Association of Internal Medicine)
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대퇴동맥 가성동맥류의 풍선 차단법을 이용한 트롬빈 주입요법 치료 1예

Percutaneous Thrombin Injection with Balloon Occlusion for the Treatment of a Femoral Artery Pseudoaneurysm

  • 김병식 (한양대학교 의과대학 한양대학교 구리병원 내과) ;
  • 신정훈 (한양대학교 의과대학 한양대학교 구리병원 내과) ;
  • 김유신 (한양대학교 의과대학 한양대학교 구리병원 내과) ;
  • 이용구 (한양대학교 의과대학 한양대학교 구리병원 내과) ;
  • 김진우 (한양대학교 의과대학 한양대학교 구리병원 영상의학과) ;
  • 박환철 (한양대학교 의과대학 한양대학교 구리병원 내과) ;
  • 최성일 (한양대학교 의과대학 한양대학교 구리병원 내과)
  • Kim, Byung Sihk (Departments of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine) ;
  • Shin, Jeong Hun (Departments of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine) ;
  • Kim, You Shin (Departments of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine) ;
  • Lee, Yonggu (Departments of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine) ;
  • Kim, Jinoo (Departments of Radiology, Hanyang University Guri Hospital, Hanyang University College of Medicine) ;
  • Park, Hwan-Cheol (Departments of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine) ;
  • Choi, Sung-Il (Departments of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine)
  • 투고 : 2013.01.24
  • 심사 : 2013.06.26
  • 발행 : 2014.04.01
⟨ 이전 논문 다음 논문 ⟩

초록

관상동맥 조영술을 시행받은 75세 여자 환자에서 좌측 대퇴동맥 천자 부위의 가성동맥류가 발생하였다. 초음파 유도압박법으로 가성동맥류의 치료가 실패하였고 가성동맥류의 경부가 짧고 넓어 누출의 위험이 높아 풍선카테터를 통하여 대퇴동맥을 일시적으로 폐쇄하고 경피적 트롬빈 주입요법을 시행하여 치료한 증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

Femoral artery pseudoaneurysm (FAP) is an uncommon but potentially serious vascular complication that may develop after cardiac and peripheral angiographic procedures. Here we describe the case of a 75-year-old female who presented with a life-threatening bleeding episode due to an FAP 4 days after diagnostic coronary angiography, which was treated with a percutaneous thrombin injection and transient balloon occlusion of the femoral artery during thrombin injection. This case reminds us of the importance of close observation and proper evaluation for complications, even if the risk of bleeding complications is low. Furthermore, although ultrasound-guided compression and a percutaneous thrombin injection are the standard treatment for FAP, this case demonstrates that transient balloon dilation during the percutaneous injection of thrombin is an important treatment option in cases of a wide-necked pseudoaneurysm in which the risk of thrombin escape is high.

키워드

참고문헌

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