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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

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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