학술논문
Percutaneous thrombin injection under contrast-enhanced ultrasound guidance to control active extravasation not associated with pseudoaneurysm.
Document Type
Academic Journal
Author
Moschouris H; Department of Radiology, Tzaneio Prefecture General Hospital of Piraeus, Piraeus, Greece.; Papadaki MG; Department of Radiology, Tzaneio Prefecture General Hospital of Piraeus, Piraeus, Greece.; Spanomanolis N; Department of Radiology, Tzaneio Prefecture General Hospital of Piraeus, Piraeus, Greece.; Stamatiou K; Department of Urology, Tzaneio Prefecture General Hospital of Piraeus, Piraeus, Greece.; Malagari K; Department of Radiology, Attikon General University Hospital of Athens, Athens, Greece.
Source
Publisher: Galenos Publishing House Country of Publication: Turkey NLM ID: 101241152 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1305-3612 (Electronic) Linking ISSN: 13053825 NLM ISO Abbreviation: Diagn Interv Radiol Subsets: MEDLINE
Subject
Language
English
Abstract
The technique of percutaneous thrombin injection (PTI) under contrast-enhanced ultrasound (CEUS) guidance for control of acute hemorrhage-active extravasation not associated with pseudoaneurysm is demonstrated in three cases: 1) Massive spontaneous retroperitoneal hematoma in a patient with multiple comorbidities. Contrast-enhanced computed tomography (CT) showed extensive active extravasation, which was only partially controlled by transarterial embolization. CEUS was performed in the angiography suite. Contrary to unenhanced US and colour Doppler US (CDUS), CEUS confirmed persistent extravasation; CEUS-guided PTI was performed immediately thereafter. 2) Large rectus sheath hematoma in a patient on anticoagulant therapy. Contrast-enhanced CT and unenhanced US/CD could not definitely diagnose extravasation. CEUS clearly showed extravasation and was used for guidance of PTI. 3) Chest wall hematoma complicating central venous catheter placement in a patient with coronavirus on anticoagulant therapy. CDUS was inconclusive. CEUS was performed at the bedside, clearly showed active extravasation, and was used for guidance of PTI. In all three cases, post-PTI CEUS confirmed the absence of residual enhancement of the hematomas, and the hemodynamic status of the patients improved. PTI appears to be effective in selected cases of hematomas associated with active extravasation. In this context, CEUS may be the most suitable modality for guidance and for an immediate evaluation of the treatment effect.