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This version was published on July 1, 2008
Angiology, Vol. 59, No. 3, 372-375 (2008)
DOI: 10.1177/0003319707304575

Percutaneous Thrombin Injection for Treatment of Iatrogenic Femoral Artery Pseudoaneurysms: A Case for Caution

Marc-Alexander Ohlow, MD

Klinik für Kardiologie, Zentralklinik, m.ohlow.kar{at}zentralklinik-bad-berka.de

Maria-Anna Secknus, MD

Klinik für Kardiologie, Zentralklinik

Hubertus von Korn, MD

Klinik für Kardiologie, Zentralklinik

Reginald Weiss, MD

Klinik für Angiologie, Zentralklinik, Bad Berka, Germany

Bernward Lauer, MD, PhD

Klinik für Kardiologie, Zentralklinik

The case of a patient who developed a femoral artery pseudoaneurysm following cardiac catheterization is described. After 2 failed attempts of ultrasound-guided compression repair, the patient underwent percutaneous thrombin injection with, beside of complete closure of the pseudoaneurysm, a severe limb ischemia due to distal thrombin migration with consecutive clot formation finally resulting in thigh amputation of the affected leg. Indications, advantages, and disadvantages of various options for the treatment of iatrogenic femoral artery pseudoaneurysms (vascular surgery, ultrasound-guided compression, percutaneous thrombin injection, and other nonsurgical treatment modalities), as well as risk factors for distal migration of liquid thrombin after percutaneous injection, are discussed in this report.

Key Words: cardiac catheterization • pseudoaneurysm • femoral artery • thrombin injection


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