Advertisement

Indian Journal of Gastroenterology

, Volume 37, Issue 3, pp 271–275 | Cite as

Endoscopic ultrasound-guided thrombin injection for management of visceral artery pseudoaneurysm: A novel approach

  • Ashok Jhajharia
  • Shashank Wanjari
  • Prachis Ashdhir
  • Deepak Sharma
  • Rupesh Pokharna
  • Sandeep Nijhawan
Case Series
  • 28 Downloads

Abstract

Visceral artery pseudoaneurysm is a rare and potentially life-threatening vascular entity with a high mortality rate, conventionally managed with digital subtraction angiography with coil embolization or surgery. However, in cases where angiographic coil embolization is not possible due to technical reasons, computerized tomography (CT)/ultrasonography-guided thrombin injection remains a viable option as described in the literature. In this case series, we intend to highlight the role of endoscopic ultrasound-guided thrombin injection in the management of abdominal visceral artery pseudoaneurysm, which is either inaccessible by endovascular route or have high surgical risk of complication.

Keywords

Angiography Endoscopic ultrasound Pseudoaneurysm Thrombin 

Notes

Compliance with ethical standards

Conflict of interest

AJ, SW, PA, DS, RP, and SN declare that they have no conflict of interest.

References

  1. 1.
    Kim MD, Kim H, Kang SW, Jeong BG. Nontraumatic hepatic artery pseudoneurysm associated with acute leukemia: a possible complication of pyogenic liver abscess. Abdom Imaging. 2002;27:458–60.CrossRefPubMedGoogle Scholar
  2. 2.
    Won YD, Ku YM, Kim KT, Kim KH, Kim JI. Successful management of a ruptured hepatic artery pseudoaneurysm with stent-graft. Emerg Radiol. 2009;16:247–9.CrossRefPubMedGoogle Scholar
  3. 3.
    Iyori K, Horigome M, Yumoto S, et al. Aneurysm of the gastroduodenal artery associated with absence of the celiac axis: report of a case. Surg Today. 2004;34:360–2.Google Scholar
  4. 4.
    Chong WW, Tan SG, Htoo MM. Endovascular treatment of gastroduodenal artery aneurysm. Asian Cardiovasc Thorac Ann. 2008;16:68–72.CrossRefPubMedGoogle Scholar
  5. 5.
    Elford J, Burrell C, Freeman S, Roobottom C. Human thrombin injection for the percutaneous treatment of iatrogenic pseudoaneurysms. Cardiovasc Intervent Radiol. 2002;25:115–8.CrossRefPubMedGoogle Scholar
  6. 6.
    Sparrow P, Asquith J, Chalmers N. Ultrasonic guided percutaneous injection of pancreatic pseudoaneurysm with thrombin. Cardiovasc Intervent Radiol. 2003;26:312–5.CrossRefPubMedGoogle Scholar
  7. 7.
    Vlachou PA, Karkos CD, Bains S, McCarthy MJ, Fishwick G, Bolia A. Percutaneous ultrasound guided thrombin injection for the treatment of iatrogenic femoral artery pseudoaneurysms. Eur J Radiol. 2011;77:172–4.CrossRefPubMedGoogle Scholar
  8. 8.
    Quarmby JW, Engelke C, Chitolie A, Morgan RA, Belli AM. Autologous thrombin for treatment of pseudoaneurysms. Lancet. 2002;359:946–7.CrossRefPubMedGoogle Scholar
  9. 9.
    Puri S, Nicholson AA, Breen DJ. Percutaneous thrombin injection for the treatment of a post-pancreatitis pseudoaneurysm. Eur Radiol. 2003;13 Suppl 4:L79–82.CrossRefPubMedGoogle Scholar
  10. 10.
    Armstrong EM, Edwards A, Kingsnorth AN, Freeman S, Roobottom CA. Ultrasound guided thrombin injection to treat a pseudoaneurysm secondary to chronic pancreatitis. Eur J Vasc Endovasc Surg. 2003;26:448–9.CrossRefPubMedGoogle Scholar

Copyright information

© Indian Society of Gastroenterology 2018

Authors and Affiliations

  • Ashok Jhajharia
    • 1
  • Shashank Wanjari
    • 1
  • Prachis Ashdhir
    • 1
  • Deepak Sharma
    • 1
  • Rupesh Pokharna
    • 1
  • Sandeep Nijhawan
    • 1
  1. 1.Department of GastroenterologySMS Medical College and HospitalJaipurIndia

Personalised recommendations