PROCEDURES PERFORMED: Ultrasound guided thrombin injection of the groin pseudoaneurysm
CLINICAL HISTORY:
COMPARISON:
ANESTHESIA: 1% lidocaine for local anesthesia
DESCRIPTION OF PROCEDURE: A time out was performed to verify patient identity, procedure, site, side, and level as applicable. After obtaining informed consent, the patient was prepped and draped in usual sterile manner in supine position. After applying local anesthesia, a 25 G needle was advanced into the pseudoaneurysm under ultrasound guidance. units of thrombin was injected into the pseudoaneurysm. Complete thrombosis of the pseudoaneurysm was achieved. The patient tolerated the procedure without any immediate complications. Completion ultrasound shows no further flow inside the pseudoaneurysm.
IMPRESSION:
Successful thrombin injection of the groin pseudoaneurysm.
Follow up ultrasound in 1 week will be performed.
Frequently Asked Questions
What is a pseudoaneurysm and how is it treated?
A pseudoaneurysm, or false aneurysm, occurs when blood leaks out of a vessel and pools between the layers of the artery wall. Unlike true aneurysms, they are not contained by all vessel wall layers. Treatment often involves minimally invasive procedures like ultrasound-guided thrombin injection, where thrombin is injected to clot the blood within the pseudoaneurysm, effectively sealing it off.
How does ultrasound-guided thrombin injection work?
In ultrasound-guided thrombin injection, an ultrasound device is used to visualize the pseudoaneurysm and guide the needle precisely into it. Thrombin, a clot-inducing enzyme, is then injected to promote rapid blood clotting within the pseudoaneurysm, resulting in its closure. This procedure is minimally invasive and generally well-tolerated by patients.
What are the risks of thrombin injection for pseudoaneurysms?
While thrombin injection is generally safe, potential risks include allergic reactions to thrombin, infection, or damage to nearby vessels and tissues. There's also a small chance of clot migration, which could lead to complications like embolism. However, these risks are minimized with proper ultrasound guidance and sterile technique.
How should a patient prepare for a thrombin injection procedure?
Before the procedure, patients should discuss their medical history and any medications with their healthcare provider. They will likely need to fast for several hours and may need to stop taking certain blood thinners. Informed consent is obtained, and the patient is positioned supinely. Local anesthesia is administered to minimize discomfort.
What should a patient expect after a thrombin injection procedure?
After a thrombin injection, patients are typically monitored briefly for immediate complications. They may experience mild soreness at the injection site. Follow-up usually includes an ultrasound in about a week to ensure the pseudoaneurysm has resolved. Patients should report any signs of infection or unusual symptoms to their healthcare provider.
Why is local anesthesia used during thrombin injection procedures?
Local anesthesia, like 1% lidocaine, is used during thrombin injection procedures to numb the area and reduce discomfort for the patient. This allows the patient to remain awake and relaxed during the procedure while minimizing pain at the injection site.
What is the success rate of thrombin injections for pseudoaneurysms?
Thrombin injections for pseudoaneurysms have a high success rate, often above 90%, especially when guided accurately by ultrasound. The procedure's effectiveness largely depends on the size and location of the pseudoaneurysm as well as the patient's overall health.