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Korean J Med. 2014;86(4):484-488. Published online April 1, 2014.
DOI: https://doi.org/10.3904/kjm.2014.86.4.484
대퇴동맥 가성동맥류의 풍선 차단법을 이용한 트롬빈 주입요법 치료 1예
김병식1, 신정훈1, 김유신1, 이용구1, 김진우2, 박환철1, 최성일1
1한양대학교 의과대학 한양대학교 구리병원 내과
2한양대학교 의과대학 한양대학교 구리병원 영상의학과
Percutaneous Thrombin Injection with Balloon Occlusion for the Treatment of a Femoral Artery Pseudoaneurysm
Byung Sihk Kim1, Jeong Hun Shin1, You Shin Kim1, Yonggu Lee1, Jinoo Kim2, Hwan-Cheol Park1, Sung-Il Choi1
1Departments of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
2Departments of Radiology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
Corresponding author: Jeong Hun Shin ,Tel: +82-31-560-2599, Fax: +82-31-560-2598, Email: cardio.hyapex@gmail.com
Received: January 24, 2013; Revised: May 15, 2013   Accepted: June 26, 2013.
관상동맥 조영술을 시행받은 75세 여자 환자에서 좌측 대퇴동맥 천자 부위의 가성동맥류가 발생하였다. 초음파 유도압박법으로 가성동맥류의 치료가 실패하였고 가성동맥류의 경부가 짧고 넓어 누출의 위험이 높아 풍선카테터를 통하여 대퇴동맥을 일시적으로 폐쇄하고 경피적 트롬빈 주입요법을 시행하여 치료한 증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

߽ɾ :대퇴동맥; 가성동맥류; 트롬빈
Abstract
Femoral artery pseudoaneurysm (FAP) is an uncommon but potentially serious vascular complication that may develop after cardiac and peripheral angiographic procedures. Here we describe the case of a 75-year-old female who presented with a lifethreatening bleeding episode due to an FAP 4 days after diagnostic coronary angiography, which was treated with a percutaneous thrombin injection and transient balloon occlusion of the femoral artery during thrombin injection. This case reminds us of the importance of close observation and proper evaluation for complications, even if the risk of bleeding complications is low. Furthermore, although ultrasound-guided compression and a percutaneous thrombin injection are the standard treatment for FAP, this case demonstrates that transient balloon dilation during the percutaneous injection of thrombin is an important treatment option in cases of a wide-necked pseudoaneurysm in which the risk of thrombin escape is high. (Korean J Med 2014;86:484-488)

Keywords :Femoral artery, Pseudoaneurysm, Thrombin
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