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Información de la revista
Vol. 59. Núm. 6.
Páginas 421-426 (Enero 2007)
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Vol. 59. Núm. 6.
Páginas 421-426 (Enero 2007)
Acceso a texto completo
Estudio prospectivo del tratamiento de los pseudoaneurismas de la arteria femoral con inyección de trombina guiada por ultrasonido: hacia una terapia menos invasiva
A prospective study of the treatment of pseudoaneurysms in the femoral arterywith ultrasound-guided thrombin injections: towards a less invasive therapy
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D.M. Olsen, J.A. Rodríguez, M. Vranic, V. Ramaiah, R. Ravi, E. Diethrich, C. Jiménez
Autor para correspondencia
cesarejmd@yahoo.com

Correspondencia: Arizona Heart Hospital. 1930 East Thomas Road. Phoenix, AZ 85016, Estados Unidos.
Arizona Heart Hospital. Phoenix, Arizona, Estados Unidos
Información del artículo
Resumen
Bibliografía
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Estadísticas
Resumen
Introducción

Los procedimientos endovasculares en los que se cateteriza la arteria femoral pueden complicarse con la formación de pseudoaneurismas. Recientemente se ha utilizado una técnica menos mórbida que utiliza inyección de trombina guiada por ultrasonido (ITGU) en el saco aneurismático.

Objetivo

Evaluar de manera prospectiva la efectividad de la ITGU como tratamiento de los pseudoaneurismas iatrogénicos de la arteria femoral.

Pacientes y métodos

Se realizaron 3.734 cateterizaciones de la arteria femoral. Treinta y dos pacientes desarrollaron 33 pseudoaneurismas de la arteria femoral (0,88%) de menos de 8 cm; este grupo de pacientes se sometió a ITGU y fue seguido de manera prospectiva.

Resultados

La incidencia inicial de éxito fue del 100%. Treinta y un casos (93,9%) permanecieron trombosados de manera exitosa con una sola inyección, controlados hasta el día 30. Dos pseudoaneurismas recurrieron los días 1 y 8 después del procedimiento (6,1%). Mas de la mitad de los pacientes fueron pacientes hospitalizados (53,1%). Al 88,2% de los pacientes se les dio de alta en el primer o segundo día. Diez de los últimos 11 casos necesitaron menos de 800 UI y casi la mitad de los pseudoaneurismas (49%) se trombosaron con éxito utilizando menos de 600 UI. No se demostró una relación estadísticamente significativa entre la aparición del pseudoaneurisma y el tama˜o del introductor o entre el tama˜o del pseudoaneurisma y la efectividad de la trombosis.

Conclusión

La ITGU es un tratamiento efectivo. Es menos doloroso y se puede realizar de manera ambulatoria; asimismo, la terapia anticoagulante no contraindica su uso ni disminuye su efectividad. Se utilizan cantidades mínimas de trombina, lo que disminuye la incidencia de complicaciones.

Key words:
Palabras clave
Arteria femoral
Compresión
Pseudoaneurisma
Punción femoral
Trombina
Ultrasonido
Summary
Introduction

Catheterizations and endovascular procedures in which the femoral artery is cannulated are sometimes complicated by iatrogenic pseudoaneurysms. A less uncomfortable technique involving the ultrasound scanguided injection of thrombin (UGTI) has been used more recently.

Aim

To prospectively evaluate the effectiveness of UGTI as a treatment of iatrogenic femoral pseudoaneurysms.

Patients and methods

3,734 femoral artery catheterizations were performed, and from those, 32 consecutive patients with 33 femoral pseudoaneurysm (0.88%) of less than 8 cm were prospectively enrolled for UGTI.

Results

The initial success rate was 100%. Thirty-one cases (93.9%) remained successfully thrombosed with a single injection at day 30. Recurrence of two pseudoaneurysms (6.1%) was sent at day 1 and day 8. More than half of the patients were on an inpatient basis (53.1%). Hospital stay was 1 to 9 days, with 88.2% of the patients released on day or 2. Ten of the last 11 cases needed less than 800 IU, and nearly half of the pseudoaneurysms (49%) were successfully thrombosed with less than 600 IU. No statistical significance was found between occurrence of the pseudoaneurysm and sheat size or between the size of the pseudoaneurysm and successful thrombosis.

Conclusion

UGTI is an effective treatment. Not only is it minimally painful, but it can be done as an outpatient procedure and anticoagulation therapy does not hinder the success. Minimal thrombin seems necessary to successfully treat pseudoaneurysms that may further limit procedure-related complications.

Palabras clave:
Compression
Femoral artery
Femoral puncture
Pseudoaneurysm
Thrombin
Ultrasounds
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Bibliografía
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Copyright © 2007. SEACV
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