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.
References
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.
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.
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.
Chong WW, Tan SG, Htoo MM. Endovascular treatment of gastroduodenal artery aneurysm. Asian Cardiovasc Thorac Ann. 2008;16:68–72.
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.
Sparrow P, Asquith J, Chalmers N. Ultrasonic guided percutaneous injection of pancreatic pseudoaneurysm with thrombin. Cardiovasc Intervent Radiol. 2003;26:312–5.
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.
Quarmby JW, Engelke C, Chitolie A, Morgan RA, Belli AM. Autologous thrombin for treatment of pseudoaneurysms. Lancet. 2002;359:946–7.
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.
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.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
AJ, SW, PA, DS, RP, and SN declare that they have no conflict of interest.
Rights and permissions
About this article
Cite this article
Jhajharia, A., Wanjari, S., Ashdhir, P. et al. Endoscopic ultrasound-guided thrombin injection for management of visceral artery pseudoaneurysm: A novel approach. Indian J Gastroenterol 37, 271–275 (2018). https://doi.org/10.1007/s12664-018-0865-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12664-018-0865-6