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

Kim, Byung Sihk; Shin, Jeong Hun; Kim, You Shin; Lee, Yonggu; Kim, Jinoo; Park, Hwan-Cheol; Choi, Sung-Il

doi:2014.86.4.484

Korean J Med > Volume 86(4); 2014 > Article

Case Report

The Korean Journal of Medicine 2014;86(4):484-488.
Published online April 1, 2014.
DOI: https://doi.org/10.3904/kjm.2014.86.4.484

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

Byung Sihk Kim¹, Jeong Hun Shin¹, You Shin Kim¹, Yonggu Lee¹, Jinoo Kim², Hwan-Cheol Park¹, Sung-Il Choi¹

¹Departments of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
²Departments of Radiology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea

대퇴동맥 가성동맥류의 풍선 차단법을 이용한 트롬빈 주입요법 치료 1예

김병식¹, 신정훈¹, 김유신¹, 이용구¹, 김진우², 박환철¹, 최성일¹

^¹한양대학교 의과대학 한양대학교 구리병원 내과
^²한양대학교 의과대학 한양대학교 구리병원 영상의학과

Correspondence:
Jeong Hun Shin, Tel: +82-31-560-2599, Fax: +82-31-560-2598, Email: cardio.hyapex@gmail.com

Received: 24 January 2013 • Revised: 15 May 2013 • Accepted: 26 June 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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 lifethreatening 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. (Korean J Med 2014;86:484-488)

Key Words: Femoral artery; Pseudoaneurysm; Thrombin

주제어: 대퇴동맥; 가성동맥류; 트롬빈