Abstract
References
- Madhusudhan KS, Venkatesh HA, Gamanagatti S, Garg P, Srivastava DN. Interventional Radiology in the Management of Visceral Artery Pseudoaneurysms: A Review of Techniques and Embolic Materials. Korean J Radiol. 2016;17(3):351-63. https://doi.org/10.3348/kjr.2016.17.3.351
- Sessa C, Tinelli G, Porcu P, Aubert A, Thony F, Magne JL. Treatment of visceral artery aneurysms: description of a retrospective series of 42 aneurysms in 34 patients. Ann Vasc Surg. 2004;18(6):695-703. https://doi.org/10.1007/s10016-004-0112-8.
- Barbiero G, Battistel M, Susac A, Miotto D. Percutaneous thrombin embolization of a pancreatico-duodenal artery pseudoaneurysm after failing of the endovascular treatment. World J Radiol. 2014;6(8):629-35. https://doi.org/10.4329/wjr.v6.i8.629.
- Krueger K, Zaehringer M, Lackner K. Percutaneous treatment of a splenic artery pseudoaneurysm by thrombin injection. J Vasc Interv Radiol. 2005;16(7):1023-5. https://doi.org/10.1097/01.RVI.0000162167.54455.C0.
- Benjaminov O, Atri M. Percutaneous thrombin injection for treatment of an intrarenal pseudoaneurysm. AJR Am J Roentgenol. 2002;178(2):364-6. https://doi.org/10.2214/ajr.178.2.1780364.
- Casey P, Kausar A, Gavan D, Wilde N. Ultrasound-guided percutaneous thrombin for the management of superior mesenteric artery pseudoaneurysm. J Vasc Surg Cases. 2015;1(3):211-3. https://doi.org/10.1016/j.jvsc.2015.06.001.
- Siu YP, Tong MK, Leung KT, Kwan TH, Au TC, Cheung YK, Luk SH. Renal artery pseudoaneurysm following renal transplantation and treatment by percutaneous thrombin injection. Hong Kong Med J. 2006;12(1):80-1.
- Ros C, Barnes D, Fervienza A, Oses G, Alcázar JL, Martínez-Román S, Rovirosa À, Carmona F, Gómez F. Ultrasound-guided transvaginal thrombin injection of uterine arteries pseudoaneurysms. Br J Radiol. 2017;90(1074):20160913. https://doi.org/10.1259/bjr.20160913.
- Gorsi U, Agarwal V, Yaser M, Kalra N, Chaluvashetty S, Kang M, Lal A, Sandhu MS. Utility of percutaneous thrombin injection for treating visceral pseudoaneurysms. Minim Invasive Ther Allied Technol. 2021;30(3):174-8. https://doi.org/10.1080/13645706.2020.1720251.
Treatment of hemorrhagic right gastro-omental artery pseudoaneurysm via ultrasound guided percutaneous thrombin injection
Abstract
Visceral artery pseudoaneurysms are life-threatening conditions due to their high risk of rupture and hemorrhage. Traditional treatments include endovascular interventions such as stent grafting and embolization, or open surgery. However, ultrasound-guided percutaneous thrombin injection is rarely used as a first-line therapy. This case report presents a 66-year-old patient with an iatrogenic hemorrhagic pseudoaneurysm of the right gastro-omental artery, successfully treated with ultrasound-guided percutaneous thrombin injection. Under local anesthesia, a 5 mL bolus of thrombin was injected into the pseudoaneurysm sac, resulting in immediate thrombosis confirmed by ultrasound and Doppler imaging. The patient demonstrated stable hemodynamics and hemoglobin levels post-procedure. Follow-up imaging showed significant regression of hemorrhagic fluid and no contrast extravasation. This case highlights ultrasound-guided thrombin injection as a safe, cost-effective, and radiation-free alternative to traditional treatments for selected visceral artery pseudoaneurysms, particularly in distal branches or emergency settings.
Ethical Statement
Informed consent was obtained from the participant and Helsinki Declaration rules were followed to conduct this study.
Supporting Institution
No financial support was used by authors during this study.
References
- Madhusudhan KS, Venkatesh HA, Gamanagatti S, Garg P, Srivastava DN. Interventional Radiology in the Management of Visceral Artery Pseudoaneurysms: A Review of Techniques and Embolic Materials. Korean J Radiol. 2016;17(3):351-63. https://doi.org/10.3348/kjr.2016.17.3.351
- Sessa C, Tinelli G, Porcu P, Aubert A, Thony F, Magne JL. Treatment of visceral artery aneurysms: description of a retrospective series of 42 aneurysms in 34 patients. Ann Vasc Surg. 2004;18(6):695-703. https://doi.org/10.1007/s10016-004-0112-8.
- Barbiero G, Battistel M, Susac A, Miotto D. Percutaneous thrombin embolization of a pancreatico-duodenal artery pseudoaneurysm after failing of the endovascular treatment. World J Radiol. 2014;6(8):629-35. https://doi.org/10.4329/wjr.v6.i8.629.
- Krueger K, Zaehringer M, Lackner K. Percutaneous treatment of a splenic artery pseudoaneurysm by thrombin injection. J Vasc Interv Radiol. 2005;16(7):1023-5. https://doi.org/10.1097/01.RVI.0000162167.54455.C0.
- Benjaminov O, Atri M. Percutaneous thrombin injection for treatment of an intrarenal pseudoaneurysm. AJR Am J Roentgenol. 2002;178(2):364-6. https://doi.org/10.2214/ajr.178.2.1780364.
- Casey P, Kausar A, Gavan D, Wilde N. Ultrasound-guided percutaneous thrombin for the management of superior mesenteric artery pseudoaneurysm. J Vasc Surg Cases. 2015;1(3):211-3. https://doi.org/10.1016/j.jvsc.2015.06.001.
- Siu YP, Tong MK, Leung KT, Kwan TH, Au TC, Cheung YK, Luk SH. Renal artery pseudoaneurysm following renal transplantation and treatment by percutaneous thrombin injection. Hong Kong Med J. 2006;12(1):80-1.
- Ros C, Barnes D, Fervienza A, Oses G, Alcázar JL, Martínez-Román S, Rovirosa À, Carmona F, Gómez F. Ultrasound-guided transvaginal thrombin injection of uterine arteries pseudoaneurysms. Br J Radiol. 2017;90(1074):20160913. https://doi.org/10.1259/bjr.20160913.
- Gorsi U, Agarwal V, Yaser M, Kalra N, Chaluvashetty S, Kang M, Lal A, Sandhu MS. Utility of percutaneous thrombin injection for treating visceral pseudoaneurysms. Minim Invasive Ther Allied Technol. 2021;30(3):174-8. https://doi.org/10.1080/13645706.2020.1720251.
Details
| Primary Language | English |
|---|---|
| Subjects | Clinical Sciences (Other) |
| Journal Section | Case Reports |
| Authors | |
| Publication Date | April 12, 2025 |
| Submission Date | December 19, 2024 |
| Acceptance Date | January 11, 2025 |
| Published in Issue | Year 2025 Volume: 16 Issue: 54 |