Percutaneous thrombin injection under contrast-enhanced ultrasound guidance to control active extravasation not associated with pseudoaneurysm
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...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Galenos Publishing House
2023-07-01
|
| Series: | Diagnostic and Interventional Radiology |
| Subjects: | |
| Online Access: |
http://www.dirjournal.org/archives/archive-detail/article-preview/percutaneous-thrombin-injection-under-contrast-enh/57720
|
| _version_ | 1797691465885810688 |
|---|---|
| author | Hippocrates Moschouris Marina G. Papadaki Nektarios Spanomanolis Konstantinos Stamatiou Katerina Malagari |
| author_facet | Hippocrates Moschouris Marina G. Papadaki Nektarios Spanomanolis Konstantinos Stamatiou Katerina Malagari |
| author_sort | Hippocrates Moschouris |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-12T02:13:42Z |
| format | Article |
| id | doaj.art-fc941257659542df8a32c739c0b7b35e |
| institution | Directory Open Access Journal |
| issn | 1305-3825 1305-3612 |
| language | English |
| last_indexed | 2024-03-12T02:13:42Z |
| publishDate | 2023-07-01 |
| publisher | Galenos Publishing House |
| record_format | Article |
| series | Diagnostic and Interventional Radiology |
| spelling | doaj.art-fc941257659542df8a32c739c0b7b35e2023-09-06T11:44:50ZengGalenos Publishing HouseDiagnostic and Interventional Radiology1305-38251305-36122023-07-0129463263710.4274/dir.2022.22157713049054Percutaneous thrombin injection under contrast-enhanced ultrasound guidance to control active extravasation not associated with pseudoaneurysmHippocrates Moschouris0Marina G. Papadaki1Nektarios Spanomanolis2Konstantinos Stamatiou3Katerina Malagari4 Department of Radiology, Tzaneio Prefecture General Hospital of Piraeus, Piraeus, Greece Department of Radiology, Tzaneio Prefecture General Hospital of Piraeus, Piraeus, Greece Department of Radiology, Tzaneio Prefecture General Hospital of Piraeus, Piraeus, Greece Department of Urology, Tzaneio Prefecture General Hospital of Piraeus, Piraeus, Greece Department of Radiology, Attikon General University Hospital of Athens, Athens, Greece 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. http://www.dirjournal.org/archives/archive-detail/article-preview/percutaneous-thrombin-injection-under-contrast-enh/57720 percutaneous thrombin injectioncontrast-enhanced ultrasoundhematomaactive extravasation |
| spellingShingle | Hippocrates Moschouris Marina G. Papadaki Nektarios Spanomanolis Konstantinos Stamatiou Katerina Malagari Percutaneous thrombin injection under contrast-enhanced ultrasound guidance to control active extravasation not associated with pseudoaneurysm Diagnostic and Interventional Radiology percutaneous thrombin injection contrast-enhanced ultrasound hematoma active extravasation |
| title | Percutaneous thrombin injection under contrast-enhanced ultrasound guidance to control active extravasation not associated with pseudoaneurysm |
| title_full | Percutaneous thrombin injection under contrast-enhanced ultrasound guidance to control active extravasation not associated with pseudoaneurysm |
| title_fullStr | Percutaneous thrombin injection under contrast-enhanced ultrasound guidance to control active extravasation not associated with pseudoaneurysm |
| title_full_unstemmed | Percutaneous thrombin injection under contrast-enhanced ultrasound guidance to control active extravasation not associated with pseudoaneurysm |
| title_short | Percutaneous thrombin injection under contrast-enhanced ultrasound guidance to control active extravasation not associated with pseudoaneurysm |
| title_sort | percutaneous thrombin injection under contrast enhanced ultrasound guidance to control active extravasation not associated with pseudoaneurysm |
| topic | percutaneous thrombin injection contrast-enhanced ultrasound hematoma active extravasation |
| url |
http://www.dirjournal.org/archives/archive-detail/article-preview/percutaneous-thrombin-injection-under-contrast-enh/57720
|
| work_keys_str_mv | AT hippocratesmoschouris percutaneousthrombininjectionundercontrastenhancedultrasoundguidancetocontrolactiveextravasationnotassociatedwithpseudoaneurysm AT marinagpapadaki percutaneousthrombininjectionundercontrastenhancedultrasoundguidancetocontrolactiveextravasationnotassociatedwithpseudoaneurysm AT nektariosspanomanolis percutaneousthrombininjectionundercontrastenhancedultrasoundguidancetocontrolactiveextravasationnotassociatedwithpseudoaneurysm AT konstantinosstamatiou percutaneousthrombininjectionundercontrastenhancedultrasoundguidancetocontrolactiveextravasationnotassociatedwithpseudoaneurysm AT katerinamalagari percutaneousthrombininjectionundercontrastenhancedultrasoundguidancetocontrolactiveextravasationnotassociatedwithpseudoaneurysm |