대퇴동맥 가성동맥류의 풍선 차단법을 이용한 트롬빈 주입요법 치료 1예

Abstract

관상동맥 조영술을 시행받은 75세 여자 환자에서 좌측 대퇴동맥 천자 부위의 가성동맥류가 발생하였다. 초음파 유도압박법으로 가성동맥류의 치료가 실패하였고 가성동맥류의경부가 짧고 넓어 누출의 위험이 높아 풍선카테터를 통하여대퇴동맥을 일시적으로 폐쇄하고 경피적 트롬빈 주입요법을시행하여 치료한 증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.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 life-threatening 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 optionin cases of a wide-necked pseudoaneurysm in which the risk of thrombin escape is high. (Korean J Med 2014;86:484-488)