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ITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY

A Journal on Vascular and Endovascular Surgery


Official Journal of the Italian Society of Vascular and Endovascular Surgery
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Giornale Italiano di Chirurgia Vascolare 1999 December;6(4):281-90

Copyright © 2000 EDIZIONI MINERVA MEDICA

language: English, Italian

Induced thrombosis employing arteriographic guide: a new technique in the treatment of iatrogenic pseudoaneurysms

Mangialardi N., Podda I., Serrao E., Tuccimei I., Ramacci R., Zavattaro E., Giordano G. A., Tozzi A.

From the Vascular Surgery Operating Unit (Head: Prof. N. Mangialardi) Azienda Complesso Ospedaliero San Filippo Neri, Rome


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Background. Ultrasound-guid­ed com­pres­sion and oth­er ­mini-inva­sive tech­niques devel­oped as alter­na­tive meth­ods of clos­ing iat­ro­gen­ic pseu­do­an­eu­rysms (­stent or ­coil place­ment, throm­bin injec­tion) ­present a num­ber of draw­backs ­linked to ana­tom­ic con­di­tions, anti­co­ag­u­la­tion stat­us, ­local ­pain, ­long com­pres­sion ­times, for­eign mate­ri­als ­left ­inside the ­body and ­adverse reac­tions. The aim of ­this ­study was to eval­u­ate the effi­ca­cy, ­results and lim­its of a new meth­od of treat­ing pseu­do­an­eu­rysms ­using a sim­ple arte­ri­o­graph­ic ­guide.
Methods. A ­total of 12 post­cath­er­iza­tion pseu­do­an­eu­rysms ­were treat­ed. Seven ­patients under­went the pro­ce­dure due to the fail­ure or impos­sibil­ity of ­using ultra­sound-guid­ed com­pres­sion. The pro­ce­dure was ­used direct­ly in ­five ­patients. Pseudoaneurysms ­were direct­ly punc­tured and an arte­ri­o­graph­ic ­guide was intro­duced ­into the cav­ity. The ­guide was ­then ­removed ­after two ­hours’ com­pres­sion ­using Femostop. All ­patients under­went ­echo-Doppler and arter­i­og­ra­phy at the end of the pro­ce­dure. A con­trol ­echo-Doppler was repeat­ed one ­month and six ­months ­after the pro­ce­dure in all ­patients.
Results. All pseu­do­an­eu­rysms treat­ed ­were ­closed. No pro­ce­dure-relat­ed ­local and gen­er­al com­pli­ca­tions ­were report­ed. The fol­low-up ­echo-Doppler exam­ina­tion ­showed no recur­rence in any of the ­patients.
Conclusions. This tech­nique is high­ly effec­tive and ­safe. It has no lim­its relat­ing to ana­tom­i­cal (­site and diam­e­ter of pseu­do­aneu­rysm) and phar­mac­o­log­i­cal con­di­tions (anti­co­ag­u­la­tion ther­a­py).

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