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Troupe C, Kitley C. Spontaneous pseudoaneurysm of profunda femoris artery following a musculoskeletal sports injury. Radiol Case Rep 2023; 18:3400-3405. [PMID: 37502487 PMCID: PMC10369378 DOI: 10.1016/j.radcr.2023.06.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 06/28/2023] [Indexed: 07/29/2023] Open
Abstract
Pseudoaneurysms are relatively common entities encountered in clinical practice; however, pseudoaneurysms of the profunda femoris artery are rarely reported in literature. Due to the nonspecific presentation of pseudoaneurysms, diagnosis can be difficult and delayed. We report a case of a 14-year-old athlete diagnosed with spontaneous pseudoaneurysm of profunda femoris artery following a sports injury. Presentation, diagnostic workup, treatment, and complications are described.
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Affiliation(s)
- Carly Troupe
- University of Missouri School of Medicine, Columbia, MO 65212, USA
| | - Charles Kitley
- Department of Radiology, University of Missouri, Columbia, MO 65212, USA
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2
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Wang Y, Zheng H, Yao W, Ju S, Bai Y, Wang C, Zhou C, Liu J, Yang C, Huang S, Li T, Chen Y, Xiong B. Management of traumatic peripheral artery pseudoaneurysm: A 10-year experience at a single center. J Interv Med 2023; 6:29-34. [PMID: 37180364 PMCID: PMC10167504 DOI: 10.1016/j.jimed.2022.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 10/12/2022] [Accepted: 10/31/2022] [Indexed: 11/11/2022] Open
Abstract
Purpose This study aimed to report our 10-year experience with the management of iatrogenic (penetrating trauma) and traumatic (blunt or penetrating trauma) peripheral artery pseudoaneurysms, based on data from a tertiary referral center. Methods From January 2012 to December 2021, the medical records of consecutive patients with iatrogenic and traumatic peripheral artery pseudoaneurysms were retrospectively reviewed. Patient demographics, clinical features, imaging data, treatment details, and follow-up results were analyzed. Results Sixty-one consecutive patients were included in this study; 48 (79%) were men and 13 (21%) women, with a mean age of 49.4 ± 13.4 years (range 24-73 years). There were 42 patients (69%) who underwent open surgery, 18 (29%) undergoing endovascular embolization or stent implantation, and one (2%) undergoing ultrasound-guided thrombin injection. All patients successfully underwent open or interventional treatment. The median follow-up was 46.8 months (2.5-117.9 months), and the overall reintervention rate was 10%. Of these, one (5%) patient in the interventional treatment group and five (12%) patients in the open surgery group underwent reintervention. The overall complication rate was 8%, with complications occurring only in the open surgery group. No deaths occurred in the peri-operative period. No late complications, such as thrombosis or pseudoaneurysm recurrence, were observed. Conclusion Peripheral artery pseudoaneurysms arising from iatrogenic or traumatic causes can be effectively treated by both open surgery and interventional procedures in selected patients with acceptable mid- and long-term outcomes.
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Affiliation(s)
- Yingliang Wang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Hubei Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Hai Zheng
- Department of Emergency Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Wei Yao
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Hubei Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Shuguang Ju
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Hubei Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Yaowei Bai
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Hubei Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Chaoyang Wang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Hubei Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Chen Zhou
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Hubei Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Jiacheng Liu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Hubei Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Chongtu Yang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Hubei Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Songjiang Huang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Hubei Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Tongqiang Li
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Hubei Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Yang Chen
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Hubei Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Bin Xiong
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Hubei Key Laboratory of Molecular Imaging, Wuhan, 430022, China
- Department of Interventional Radiology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
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Stern M, Schremmer J, Scharm S, Baasen S, Heinen Y, Sansone R, Polzin A, Jung C, Heiss C, Kelm M, Busch L. Microvascular tissue perfusion after postcatheterization pseudoaneurysm treatment. Clin Hemorheol Microcirc 2022; 82:275-282. [PMID: 35938240 DOI: 10.3233/ch-221438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Femoral pseudoaneurysm (PSA) is a severe complication after endovascular procedures. Ultrasound-guided manual compression (MC) and percutaneous thrombin injection (TI) are frequently used treatments. MC is less effective, TI may cause thromboembolic events. OBJECTIVE Up to date, there is no data regarding impairment of microvascular tissue perfusion after PSA treatment. METHODS In this single-center, prospective study 22 patients with PSA were included. We compared macro- and microcirculatory perfusion in the treated and untreated leg at baseline before, after and one day after treatment. Leg perfusion was assessed with ultrasound and ankle-brachial index (ABI). Microcirculatory perfusion of the feet was measured with a near-infrared spectroscopy (NIRS) camera generating StO2-tissue-maps. RESULTS Successful PSA thrombosis was achieved in 16 (100%) patients in TI group and in 4 (66.7%) patients in MC group. There was no evidence of arterial thrombi on ultrasound and the ABI did not differ between groups. NIRS StO2-tissue-maps of the feet showed no significant difference in both groups concerning the treated (p = 0.121) or the untreated (p = 0.198) leg during follow up. CONCLUSIONS In this small exploratory study, there was no evidence of micro- and macrovascular tissue perfusion impairment after treatment of postcatheterization femoral pseudoaneurysm with thrombin injection underscoring the safety of this approach.
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Affiliation(s)
- M Stern
- Department of Cardiology, Pulmonology, and Vascular Medicine, University Duesseldorf, Medical Faculty, Duesseldorf, Germany
| | - J Schremmer
- Department of Cardiology, Pulmonology, and Vascular Medicine, University Duesseldorf, Medical Faculty, Duesseldorf, Germany
| | - S Scharm
- Department of Cardiology, Pulmonology, and Vascular Medicine, University Duesseldorf, Medical Faculty, Duesseldorf, Germany
| | - S Baasen
- Department of Cardiology, Pulmonology, and Vascular Medicine, University Duesseldorf, Medical Faculty, Duesseldorf, Germany
| | - Y Heinen
- Department of Cardiology, Pulmonology, and Vascular Medicine, University Duesseldorf, Medical Faculty, Duesseldorf, Germany
| | - R Sansone
- Department of Cardiology, Pulmonology, and Vascular Medicine, University Duesseldorf, Medical Faculty, Duesseldorf, Germany
| | - A Polzin
- Department of Cardiology, Pulmonology, and Vascular Medicine, University Duesseldorf, Medical Faculty, Duesseldorf, Germany
| | - C Jung
- Department of Cardiology, Pulmonology, and Vascular Medicine, University Duesseldorf, Medical Faculty, Duesseldorf, Germany
| | - C Heiss
- Department of Clinical and Experimental Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom.,Department of Vascular Medicine, Surrey and Sussex NHS Healthcare Trust, Redhill, United Kingdom
| | - M Kelm
- Department of Cardiology, Pulmonology, and Vascular Medicine, University Duesseldorf, Medical Faculty, Duesseldorf, Germany.,Cardiovascular Research Institute Duesseldorf (CARID)Duesseldorf, Germany
| | - L Busch
- Department of Cardiology, Pulmonology, and Vascular Medicine, University Duesseldorf, Medical Faculty, Duesseldorf, Germany
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Watanabe S, Kanazawa R, Uchida T, Higashida T, Yamazaki K, Kono T. Endovascular Embolization of Femoral Pseudoaneurysm Associated with Therapeutic and Diagnostic Neuroendovascular Procedures. JOURNAL OF NEUROENDOVASCULAR THERAPY 2022; 17:8-14. [PMID: 37501887 PMCID: PMC10370512 DOI: 10.5797/jnet.oa.2022-0048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 10/10/2022] [Indexed: 07/29/2023]
Abstract
Objective We aimed to evaluate the usefulness of endovascular embolization for femoral iatrogenic pseudoaneurysms (PAs) following therapeutic and diagnostic neuroendovascular procedures. Methods This study included 12 patients with femoral PA due to femoral puncture at our department between May 2014 and April 2021. We performed an analysis of baseline characteristics, treatment, and outcome of these cases. Results Endovascular embolization was performed in 10 of the 12 PAs using coils and/or N-butyl-2-cyanoacrylate. Of these, 10 PAs were treated with endovascular embolization and 9 were successfully occluded, whereas complete occlusion was not achieved in 1 case of PA (success rate: 90%). No new intraoperative or postoperative complications or postoperative recurrences occurred. Conclusion Endovascular embolization for PA can be immediately performed under local anesthesia without discontinuation of antithrombotic therapy and may be a safe and effective option for access site complication treatment.
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Affiliation(s)
- Saiko Watanabe
- Department of Neurosurgery, Nagareyama Central Hospital, Nagareyama, Chiba, Japan
| | - Ryuzaburo Kanazawa
- Department of Neurosurgery, Nagareyama Central Hospital, Nagareyama, Chiba, Japan
| | - Takanori Uchida
- Department of Neurosurgery, Nagareyama Central Hospital, Nagareyama, Chiba, Japan
| | - Tetsuhiro Higashida
- Department of Neurosurgery, Nagareyama Central Hospital, Nagareyama, Chiba, Japan
| | - Kei Yamazaki
- Department of Neurosurgery, Nagareyama Central Hospital, Nagareyama, Chiba, Japan
| | - Takao Kono
- Department of Neurosurgery, Nagareyama Central Hospital, Nagareyama, Chiba, Japan
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Li L, Xiu J, Yuan L, Zhang X, Li Y. Single ultrasound-guided local high-dose thrombin injection in the treatment of giant brachial artery pseudoaneurysm: A case report. Medicine (Baltimore) 2022; 101:e30103. [PMID: 35984187 PMCID: PMC9387992 DOI: 10.1097/md.0000000000030103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
RATIONALE Pseudoaneurysm (PSA) is a common complication related to vascular intervention, and surgical therapy is the primary method. However, a giant brachial artery PSA over 2 weeks is rarely observed. Due to the adhesion of surrounding tissue, thrombus organization, the extensive injury, and the high expense of transluminal stent-graft placement, a single ultrasound-guided local high-dose thrombin injection can be a therapy option. Such cases are rarely reported. PATIENT CONCERNS A 71-year-old man with a history of left elbow fossa interventional puncture presented to our hospital with a pulsatile mass in the left elbow fossa. He had a history of cerebral infarction 32 years prior without sequelae, emphysema for more than 2 years, hyperlipidemia for 3 months, and prostatic hyperplasia for 8 months. After conservative therapy, the lumbar compression fracture produced by trauma 24 years ago healed, and the intracranial hematoma induced by trauma ten years ago was absorbed. DIAGNOSIS Ultrasound examination showed giant mixed echoes on the posterior medial side of the left brachial artery. INTERVENTIONS The patient underwent a single ultrasound-guided local high-dose thrombin injection to treat giant brachial artery PSA. OUTCOMES Following therapy, the ultrasonography revealed that extensive thrombosis immediately formed in the cavity, and the internal blood flow signals had completely vanished. A week later, a physical examination showed that the PSA had shrunk with no apparent tenderness and that the texture had hardened. Pulsation and vascular murmurs disappeared. Ultrasound showed that the PSA was reduced, and no blood flow signals were found. LESSONS A single ultrasound-guided local high-dose thrombin injection had a considerable effect in curing large iatrogenic PSA. However, when deciding on the best therapy, specificity must be taken into account.
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Affiliation(s)
- Liang Li
- Department of Ultrasound, Guang’anmen Hospital, China Academy of Traditional Chinese Medicine
| | - Junqing Xiu
- Oncology Department, South area of Guang’anmen Hospital, Academy of Traditional Chinese Medicine, China
| | - Lian Yuan
- Surgery Department, Guang’anmen Hospital, China Academy of Traditional Chinese Medicine
| | - Xing Zhang
- Oncology Department, South area of Guang’anmen Hospital, Academy of Traditional Chinese Medicine, China
| | - Yue Li
- Oncology Department, South area of Guang’anmen Hospital, Academy of Traditional Chinese Medicine, China
- *Correspondence: Yue Li, Guang’anmen Hospital, China Academy of Traditional Chinese Medicine, No.5, Beixian Pavilion, Xicheng District, Beijing, China (e-mail: )
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Kurzawski J, Zandecki L, Janion-Sadowska A, Piatek L, Jaroszynska A, Domagala S, Sadowski M, Baranska E. Choosing a treatment method for post-catheterization pseudoaneurysms guided by the late to early velocity index. Sci Rep 2021; 11:16678. [PMID: 34404860 PMCID: PMC8370979 DOI: 10.1038/s41598-021-96062-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 07/15/2021] [Indexed: 11/16/2022] Open
Abstract
Ultrasound-guided thrombin injection (UGTI) is often the first-line treatment for iatrogenic post-catheterization pseudoaneurysms (psA). There are also first reports of the use of biologically derived tissue glues (TG) instead of sole thrombin especially when UGTI was unsuccessful or in case of psA recurrence. Previously, we have established that a late to early velocity index (LEVI) < 0.2 could be a predictor of an increased risk of psA recurrence after standard UGTI. In this paper, we report our first experiences when the choice of the first-line treatment method was based on LEVI assessment. From May 2017 till January 2020 we included 36 patients with psA. Of them, 10 had LEVI < 0.2 and they underwent ultrasound-guided tissue glue injection (UGTGI) with biological TG and 26 had LEVI > 0.2 and they underwent UGTI. The injection set containing human thrombin and fibrinogen was used for UGTGI. Bovine thrombin was used for UGTI. The success rate was 100% and no psA recurrence was detected during a 2-week follow-up. It was significantly better when compared to the expected recurrence rates based on our previous 14 years of experience (0% vs. 13%, p = 0.01). All complications (10% in the UGTGI group and 15% in the UGTI group) were mild and transient and included clinical symptoms of paresthesia, numbness, tingling, or pain. Their rates were comparable to the rates we previously reported. No significant differences in other characteristics were observed. The approach to choose the first-line treatment method for iatrogenic psA based on LEVI is encouraging. It may increase the success rate and avoid unnecessary repetition of the procedure, without increasing complication rate while keeping costs of the procedure reasonable.
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Affiliation(s)
- Jacek Kurzawski
- Swietokrzyskie Cardiology Center, ul. Grunwaldzka 45, 25-736, Kielce, Poland
| | - Lukasz Zandecki
- Jan Kochanowski University, Collegium Medicum, al. IX Wiekow Kielc 19A, 25-317, Kielce, Poland.
| | | | - Lukasz Piatek
- Jan Kochanowski University, Collegium Medicum, al. IX Wiekow Kielc 19A, 25-317, Kielce, Poland
| | - Anna Jaroszynska
- Jan Kochanowski University, Collegium Medicum, al. IX Wiekow Kielc 19A, 25-317, Kielce, Poland
| | - Szymon Domagala
- Jan Kochanowski University, Collegium Medicum, al. IX Wiekow Kielc 19A, 25-317, Kielce, Poland
| | - Marcin Sadowski
- Jan Kochanowski University, Collegium Medicum, al. IX Wiekow Kielc 19A, 25-317, Kielce, Poland
| | - Edyta Baranska
- Jan Kochanowski University, Collegium Medicum, al. IX Wiekow Kielc 19A, 25-317, Kielce, Poland
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Herold J, Peters S, Juenger J, Udelnow A, Kropf S, Bauersachs R, Braun-Dullaeus R. High incidence of deep vein thrombosis during the treatment of pseudoaneurysms - a retrospective nonrandomized study. VASA 2021; 50:231-239. [PMID: 33435750 DOI: 10.1024/0301-1526/a000935] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background: Pseudoaneurysms (PSAs) are concerning complications after arterial invasive interventions. Therapeutic options include manual ultrasound-assisted compression, pressure dressings, surgical intervention and thrombin injection. Compression of neighboring veins is obvious. However, the incidence of deep vein thrombosis (DVT) in patients with PSA has not previously been investigated. Patients and methods: In this retrospective, nonrandomized study 238 patients with PSA were analyzed from 2013 to 2018. In 149 patients, all of the parameters were complete for participating. PSAs were treated according to the local standard therapy with either ultrasound-guided compression followed by compression bandage or thrombin injection. Treatment success was evaluated 24 hours later, and the venous system was examined for the presence of DVT. Results: Peripheral DVT was found in 25.4% patients after ultrasound-assisted compression and subsequent pressure bandages, but only 6.4% of patients had DVT after thrombin injection (p = 0.013). Lower leg veins, particularly veins of the crural muscles, were primarily affected. Significantly more PSAs were successfully treated without the occurrence of DVT in the thrombin injection group compared to the compression group (93.6 vs. 69.0%; p = 0.001). Conclusions: Our study revealed that the use of thrombin injections resulted in a significantly lower rate of postinterventional DVT and a higher total number of successfully treated PSAs compared to compression therapy.
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Affiliation(s)
- Joerg Herold
- Department of Vascular Medicine - Angiology, Klinikum Darmstadt, Germany.,Department of Cardiology and Angiology, Otto-von-Guericke University Magdeburg, Germany
| | - Sophie Peters
- Department of Surgery, Dietrich Bonhoeffer Diakonie Hospital, Neubrandenburg, Germany
| | - Jonas Juenger
- Children's Hospital Prinzessin Margaret, Darmstadt, Germany
| | - Andrej Udelnow
- Brandenburg Medical School "Theodor Fontane", Municipal Hospital of Brandenburg/Havel, Dpt. of Vascular and Endovascular Surgery, Brandenburg/Havel, Germany
| | - Siegfried Kropf
- Institute for Biometry and Medical Informatics, Otto-von-Guericke University Magdeburg, Germany
| | - Rupert Bauersachs
- Department of Vascular Medicine - Angiology, Klinikum Darmstadt, Germany
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Li XL, Xie CY, Xu HX, Yu SY. Contrast-enhanced ultrasound-guided thrombin injection in the management of iatrogenic pseudoaneurysm (PSA): A case report and review of literatures. Clin Hemorheol Microcirc 2020; 76:549-557. [PMID: 32924996 DOI: 10.3233/ch-200923] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Pseudoaneurysm (PSA) formation is the most common arterial complication of endovascular procedures requiring arterial puncture. The present study reported a case of a 72-year-old male patient with iatrogenic femoral artery PSA treated with contrast-enhanced ultrasound (CEUS)-guided thrombin injection. Conventional ultrasound (US) and CEUS were used to diagnose, guide treatment, and evaluate the treatment efficacy. In the case, the PSA was successfully occluded with 1000 IU of thrombin. During the follow-up after 48 hours of thrombin injection, US found that the PSA had complete thrombosis without arterial supply. No complications occurrence in the course of the treatment. CEUS-guided thrombin injection for the treatment of PSA was effective and safety and the associated literatures were also reviewed.
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Affiliation(s)
- Xiao-Long Li
- Interventional Ultrasound Unit, Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University Cancer Center, Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Tongji University School of Medicine, Shanghai, China
| | - Chen-Yi Xie
- Interventional Ultrasound Unit, Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University Cancer Center, Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Tongji University School of Medicine, Shanghai, China
| | - Hui-Xiong Xu
- Interventional Ultrasound Unit, Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University Cancer Center, Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Tongji University School of Medicine, Shanghai, China
| | - Song-Yuan Yu
- Interventional Ultrasound Unit, Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University Cancer Center, Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Tongji University School of Medicine, Shanghai, China
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Gombert A, Jacobs MJ. Sometimes Less May Be More: Thoughts About a Low Dose Protocol for Iatrogenic Femoral Pseudoaneurysm. Eur J Vasc Endovasc Surg 2020; 59:1026. [PMID: 31911138 DOI: 10.1016/j.ejvs.2019.12.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 12/02/2019] [Accepted: 12/13/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Alexander Gombert
- European Vascular Centre Aachen-Maastricht, University Hospital RWTH Aachen, Department of Vascular Surgery, Aachen, Germany.
| | - Michael J Jacobs
- European Vascular Centre Aachen-Maastricht, University Hospital RWTH Aachen, Department of Vascular Surgery, Aachen, Germany
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