Use of duplex guided stent graft placement to prevent bleeding from previously thrombosed pseudo-aneurysms during thrombolytic therapy for acute popliteal artery occlusion
Restricted accessCase reportFirst published online August, 2014
Use of duplex guided stent graft placement to prevent bleeding from previously thrombosed pseudo-aneurysms during thrombolytic therapy for acute popliteal artery occlusion
We present a 68-year-old female who developed multiple pseudo-aneurysms (PSAs) following cardiac catheterization via the right groin. During subsequent thrombin injection of PSAs, the patient developed acute occlusion of the popliteal artery. A covered stent was placed to obliterate the PSAs and allow for successful endovascular treatment of the occlusion without hemorrhage from the previous arteriotomy sites. This report demonstrates a safe and successful method to treating high surgical risk patients with recent PSA’s and a necessity for thrombolysis.
OlsenDMRodriquezJAVranicM. A prospective study of ultrasound scan-guided thrombin injection of femoral pseudoaneurysm: a trend toward minimal medication. J Vasc Surg2002; 36(4): 779–782.
3.
SackettWRTaylorSMCoffeyCB. Ultrasound-guided thrombin injection of iatrogenic femoral pseudoaneurysms: a prospective analysis. Am Surg2000; 66(10): 937–940.
4.
AhmadFTurnerSATorrieP. Iatrogenic femoral artery pseudoaneurysms-a review of current methods of diagnosis and treatment. Clin Radiol2008; 63(12): 1310–1316.
5.
SadiqSIbrahimW. Thromboembolism complicating thrombin injection of femoral artery pseudoaneurysm: management with intraarterial thrombolysis. J Vasc Interv Radiol2001; 12(5): 633–636.
6.
D’AyalaMSmithRZanieskiG. Acute arterial occlusion after ultrasound-guided thrombin injection of a common femoral artery pseudoaneurysm with a wide, short neck. Ann Vasc Surg2008; 22(3): 473–475.
7.
StawickiSPHoeyBA. Lower extremity arterial thrombosis following sonographically guided thrombin injection of a femoral pseudoaneurysm. J Clin Ultrasound2007; 35(2): 88–93.
8.
ForbesTLMillwardSF. Femoral artery thrombosis after percutaneous thrombin injection of an external iliac artery pseudoaneurysm. J Vasc Surg2001; 33(5): 1093–1096.
Smith J and Tekkis P. Risk prediction in surgery: ACPGBI CRC model results. Retrieved from www.riskprediction.org.uk (accessed 1 October 2012).
11.
KornPKhilnaniNFellersJ. Thrombolysis for native arterial occlusions of the lower extremities clinical outcome and cost. J Vasc Surg2001; 33(6): 1148–1157.
12.
van de BergJC. Thrombolysis for acute arterial occlusion. J Vasc Surg2010; 52(2): 512–515.
13.
ScheinertDLudwigJSteinkampHJ. Treatment of catheter-induces iliac artery injuries with self-expanding endografts. J Endovasc Ther2000; 7: 213–220.
14.
AscherEGopalKMarksN. Duplex-guided endovascular repair of popliteal artery aneurysms (PAAs): a new approach to avert the use of contrast material and radiation exposure. Eur J Endovasc Surg2010; 39(6): 769–773.
15.
AscherEMarksNASchutzerRW. Duplex-guided balloon angioplasty and stenting for femoropopliteal arterial occlusive disease: an alternative in patients with renal insufficiency. J Vasc Surg2005; 42(6): 1108–1113.
16.
AscherEMarksNAHingoraniAP. Duplex-guided endovascular treatment for occlusive and stenotic lesions of the femoral-popliteal arterial segment: a comparative study in the first 253 cases. J Vasc Surg2006; 44(6): 1230–1237.
17.
AscherEMarksNAHingoraniAP. Duplex-guided balloon angioplasty and subintimal dissection of infrapopliteal arteries: early results with a new approach to avoid radiation exposure and contrast material. J Vasc Surg2005; 42(6): 1114–1121.
