Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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Ultrasound-Guided Percutaneous Thrombin Injection of Femoral Artery Pseudoaneurysms Caused by Vascular Access

대퇴동맥을 통한 시술 후 발생한 가성동맥류의 초음파 유도하 경피적 트롬빈 주입 치료

  • Seung Yoon Chae (Department of Radiology, Chonnam National University Hospital) ;
  • Chan Park (Department of Radiology, Chonnam National University Hospital) ;
  • Jae Kyu Kim (Department of Radiology, Chonnam National University Hospital) ;
  • Hyoung Ook Kim (Department of Radiology, Chonnam National University Hospital) ;
  • Byung Chan Lee (Department of Radiology, Chonnam National University Hospital)
  • 채승윤 (전남대학교병원 영상의학과) ;
  • 박찬 (전남대학교병원 영상의학과) ;
  • 김재규 (전남대학교병원 영상의학과) ;
  • 김형욱 (전남대학교병원 영상의학과) ;
  • 이병찬 (전남대학교병원 영상의학과)
  • Received : 2020.06.05
  • Accepted : 2020.08.02
  • Published : 2021.05.01
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Abstract

Purpose To analyze the success and complication rates and factors associated with technical failure of the ultrasound (US)-guided percutaneous thrombin injection of femoral artery pseudoaneurysms caused by vascular access. Materials and Methods Records of 30 patients with post-catheterization femoral artery pseudoaneurysms who had been treated with US-guided percutaneous thrombin injections in the department of radiology between March 2009 and June 2019 were retrospectively analyzed. The lesion was diagnosed based on US or contrast-enhanced CT. The characteristics of the patients and their lesions were analyzed. Results The mean patient age was 67.8 years. The mean diameter of the pseudoaneurysmal sac was 20.88 mm (5-40 mm). Twenty patients (66.6%) obtained complete thrombosis after the primary injection, while 10 patients (33.3%) obtained partial thrombosis. The number of patients with a low platelet count (< 130 k/µL) was significantly higher in the partial thrombosis group than in the complete thrombosis group (p = 0.02). No substantial procedure-related complications were found in any patient. Conclusion The US-guided percutaneous thrombin injection is considered an initial treatment option for pseudoaneurysms caused by vascular access because of its safety and efficacy.

목적 대퇴동맥을 통한 시술 후 발생한 의인성 가성동맥류에 대한 초음파 유도하 경피적 트롬빈 주입 치료의 성공률과 합병증 발생률, 치료의 실패에 관련된 요인 등을 분석해 보고자 한다. 대상과 방법 2009년 3월부터 2019년 6월까지 대퇴동맥에 발생한 의인성 가성동맥류에 대하여 영상의학과에서 초음파 유도하 경피적 트롬빈 주입 치료를 받은 30명의 환자들을 후향적으로 분석하였다. 대퇴동맥의 가성동맥류는 초음파 또는 전산화단층촬영을 사용하여 진단하였으며, 환자와 병변의 특성에 대하여 분석하였다. 결과 환자들의 평균 나이는 67.8세였으며, 가성동맥류의 평균 직경은 20.88 mm (5~40 mm)였다. 첫 치료에서 20명의 환자에서 완전한 혈전형성을 보였으며(66.6%), 10명의 환자에서 부분적 혈전형성을 보였다(33.3%). 혈소판 수가 낮은 환자(< 130 k/µL)에서 부분적 혈전형성의 가능성이 유의하게 높았다. 모든 환자에서 시술 관련 합병증은 보이지 않았다. 결론 대퇴동맥의 의인성 가성동맥류에 대한 초음파 유도하 트롬빈 주입 치료는 안전하고 효과적인 우선적 치료 방법이다.

Keywords

References

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