Ultrasound-guided thrombin injection for cardiac catheterization pseudoaneurysms: efficacy, safety, and predictors

Edgar Bortolini; Tulio Fabiano de Oliveira Leite; Bruno Renan Ribeiro Gomes Linard; Breno Boueri Affonso; Cesar Higa Nomura; Joaquim Mauricio da Motta-Leal-Filho

doi:10.1177/02841851241292516

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Ultrasound-guided thrombin injection for cardiac catheterization pseudoaneurysms: efficacy, safety, and predictors

Journal article

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Ultrasound-guided thrombin injection for cardiac catheterization pseudoaneurysms: efficacy, safety, and predictors

Edgar Bortolini, Tulio Fabiano de Oliveira Leite, Bruno Renan Ribeiro Gomes Linard, Breno Boueri Affonso, Cesar Higa Nomura and Joaquim Mauricio da Motta-Leal-Filho

Acta radiologica (1987), Vol.66(1), pp.62-71

01/01/2025

DOI: 10.1177/02841851241292516

PMID: 39569541

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Abstract

Background Percutaneous ultrasound-guided thrombin injection has become the gold standard treatment for pseudoaneurysms caused by cardiac catheterization. However, failure can occur in up to 25% of the procedures and little is known about its causes. Purpose To study the efficacy and safety of the technique and to determine possible risk factors responsible for the unsuccess. Material and Methods A cohort study was carried out based on data from medical records collected between December 2012 and June 2020 of 110 patients with the diagnosis of pseudoaneurysm, femoral or radial, secondary to cardiac catheterization. Clinical data, pseudoaneurysm morphological parameters, and technical factors related to catheterization were reviewed. Results Primary and global technical success rates were 85.5% and 100%, respectively. Age, neck, and anteroposterior diameter variables were predictors of primary failure on multivariate analysis. The odds ratio (OR) for age was 0.960 (95% confidence interval [CI]=0.927–0.995; P = 0.025), for anteroposterior diameter, OR was 2.023 (95% CI=1.144–3.578; P = 0.015), and for neck diameter, it was 4.625 (95% CI=1.023–20.904; P = 0.047). The receiver operating characteristic (ROC) curve was performed for the multivariate analysis model and the three predictors of failure. The area under the curve for the multivariate analysis model was 0.695, for age it was 0.675, for anteroposterior diameter it was 0.679, and for neck diameter it was 0.676. No complications were observed. Conclusions Percutaneous ultrasound-guided thrombin injection is safe and effective for the treatment of pseudoaneurysms after cardiac catheterization. Largest anteroposterior diameter, largest neck diameter, and a younger age were independent predictors of primary failure with the technique.

Angiography

aneurysm

cardiac catheterization

false

femoral artery

therapeutic embolization

thrombin

Details

Title: Subtitle: Ultrasound-guided thrombin injection for cardiac catheterization pseudoaneurysms: efficacy, safety, and predictors
Creators: Edgar Bortolini - Universidade de São Paulo
Tulio Fabiano de Oliveira Leite - Universidade de São Paulo
Bruno Renan Ribeiro Gomes Linard - Universidade de São Paulo
Breno Boueri Affonso - Universidade de São Paulo
Cesar Higa Nomura - Universidade de São Paulo
Joaquim Mauricio da Motta-Leal-Filho - Universidade de São Paulo
Resource Type: Journal article
Publication Details: Acta radiologica (1987), Vol.66(1), pp.62-71
DOI: 10.1177/02841851241292516
PMID: 39569541
ISSN: 0284-1851
eISSN: 1600-0455
Number of pages: 10
Language: English
Date published: 01/01/2025
Academic Unit: Radiology
Record Identifier: 9985180931502771

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