Thrombin
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Thrombosis and severe ischaemia in an elderly patient: case report A 79-year-old man, who had undergone percutaneous coronary intervention, developed thrombosis and severe ischaemia requiring limb amputation after receiving a thrombin injection for treatment of a pseudoaneurysm. The man had a 2cm, short- and wide-necked pseudoaneurysm of the superficial femoral artery. Compression repair was unsuccessful and 2000IU of thrombin were therefore injected under ultrasound guidance. The pseudoaneurysm immediately clotted, but complete thrombosis of segment 3 of his popliteal artery and partial thrombosis of the right superficial femoral artery were also noted, associated with acute ischaemic syndrome of the affected leg. Findings were confirmed by angiography. Emergency surgical intervention included thrombectomy, intra-arterial thrombolysis and patch angioplasty of the popliteal and superficial femoral arteries. However, the man’s ischaemic syndrome persisted and he required thigh amputation 4 days later. Ohlow M-A, et al. Percutaneous thrombin injection for treatment of iatrogenic femoral artery pseudoaneurysms: a case for caution. Angiology 59: 372-375, No. 801111659 3, Jun-Jul 2008 - Germany
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Reactions 21 Jun 2008 No. 1207
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