Ultrasound-guided thrombin injection (UGTI) has emerged as the first-line treatment for moderately sized or persistent pseudoaneurysms (PSAs). Although rare, the most feared complication of UGTI is arterial thrombosis or embolism during the off-label injection of thrombin causing acute limb ischemia requiring emergent surgical intervention. Higher thrombin volume, rapidity of injection, and wide or short-neck PSAs are all thought to increase the risk of arterial thrombosis or embolism during this procedure. For patients with unfavorable PSA anatomy who are high-risk surgical candidates due to their medical comorbidities or active critical illness, balloon-assisted thrombin injection (BATI) has been suggested as a means to potentially reduce the risk of thrombosis or distal embolization associated with UGTI. This minimally invasive technique also decreases the risk of groin wound dehiscence or infection associated with open repair, especially in patients who are morbidly obese or have had prior groin surgery. We report a patient with a complex femoral artery PSA after endovascular intervention who was successfully treated with BATI and describe the procedure in detail.

中文翻译：

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球囊辅助超声引导经皮凝血酶注射医源性股动脉假性动脉瘤：病例报告和技术说明

超声引导凝血酶注射 (UGTI) 已成为中等大小或持续性假性动脉瘤 (PSA) 的一线治疗方法。虽然罕见，但 UGTI 最令人恐惧的并发症是在超适应证注射凝血酶期间发生动脉血栓形成或栓塞，导致需要紧急手术干预的急性肢体缺血。较高的凝血酶体积、注射速度以及宽颈或短颈 PSA 都被认为会增加此过程中动脉血栓形成或栓塞的风险。对于因合并症或活动性危重病而成为高危手术候选者的 PSA 解剖结构不利的患者，已建议球囊辅助凝血酶注射 (BTI) 作为潜在降低与 UGTI 相关的血栓形成或远端栓塞风险的一种方法. 这种微创技术还降低了与开放修复相关的腹股沟伤口裂开或感染的风险，尤其是在病态肥胖或之前接受过腹股沟手术的患者中。我们报告了一名接受 BATI 成功治疗的血管内介入术后复杂股动脉 PSA 患者，并详细描述了手术过程。