Repeated Percutaneous Thrombin Injections as Treatment of a Large Iatrogenic Pseudoaneurysm in the Artery Supplying a Haemodialysis Arteriovenous Fistula
NR Mahboobani, LF Cheng, JKF Ma
Hong Kong J Radiol 2018;21:e12-7
DOI: 10.12809/hkjr1816431
We report a case of obliteration of a large radial artery pseudoaneurysm complicating venous angioplasty in a patient with a left forearm Brescia-Cimino fistula. Obliteration was by combined balloon-assisted and ultrasound-guided direct percutaneous thrombin injections. The procedure was performed twice. There was subsequent salvage of the fistula with restoration of function and minimal cosmetic disfiguration following subsequent pseudoaneurysm shrinkage. This procedure provides a safe treatment of such complications and can be repeated. We describe the procedure and its advantages and discuss other treatment options.
Author affiliation(s):
NR Mahboobani, LF Cheng, JKF Ma: Department of Radiology, Princess Margaret Hospital, Laichikok, Hong Kong
中文摘要
重複經皮凝血酶注射治療動脈供應血液透析動靜脈瘻的大型醫源性假性動脈瘤
馬承志、鄭力暉、馬嘉輝
本文報告1例左前臂Brescia-Cimino瘻患者靜脈血管成形術併發大橈動脈假性動脈瘤的閉塞治療。通過氣囊輔助和超聲引導的直接經皮凝血酶注射聯合進行閉塞。該過程進行了兩次。在隨後的假性動脈瘤收縮後，隨後恢復功能和最小外觀上的變形，瘻管隨後收縮。該方法提供對這些併發症的安全治療，並且可以重複進行。我們描述其過程和優點，並討論其他治療方案。