Management of Visceral Artery Pseudoaneurysms by Combined Technique of Percutaneous Thrombin Injection and Endovascular Coiling
Purpose To describe our initial experience with percutaneous thrombin injection combined with endovascular coiling of high-flow visceral artery pseudoaneurysms. Materials and Methods Institutional review board approval was obtained. Between January 2019 and February 2020, 21 patients with...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Thieme Medical Publishers, Inc.
2021-06-01
|
| Series: | Journal of Clinical Interventional Radiology ISVIR |
| Subjects: | |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1728977 |
| _version_ | 1818681856063700992 |
|---|---|
| author | Kalpana Sivalingam Karthik Palanisamy Amalan Ignatius |
| author_facet | Kalpana Sivalingam Karthik Palanisamy Amalan Ignatius |
| author_sort | Kalpana Sivalingam |
| collection | DOAJ |
| description | Purpose To describe our initial experience with percutaneous thrombin injection combined with endovascular coiling of high-flow visceral artery pseudoaneurysms.
Materials and Methods Institutional review board approval was obtained. Between January 2019 and February 2020, 21 patients with nonvariceal upper gastrointestinal (GI) bleed underwent multidetector CT angiography. Four patients with acute pancreatitis and large pseudoaneurysms were selected for the combined technique. Human thrombin reconstituted with calcium chloride was injected percutaneously. Partially thrombosed aneurysms were treated up to three times. Simultaneously or within 15 days, coil embolization of the neck or patent part of pseudoaneurysm was performed. Patients were followed up to 1 month postprocedure.
Results The size of the pseudoaneurysms ranged from 3 cm to 6 cm. All were accessed percutaneously by 22G Chiba needle under ultrasound guidance and 500 to 1500 units of thrombin was injected in one to three attempts. Subsequently, endovascular coiling of the neck of the pseudoaneurysm or of the feeding artery was performed. Technical success with cessation of flow was achieved in all four patients. One patient developed obstructive jaundice postprocedure and another continued to have GI bleeding despite thrombin injection.
Conclusion Percutaneous thrombin injection is an easy to use and effective tool for treating visceral artery pseudoaneurysms and can be combined with endovascular coiling for successful occlusion of large pseudoaneurysms. |
| first_indexed | 2024-12-17T10:09:35Z |
| format | Article |
| id | doaj.art-c8fad5aed0004004a6d3c7dcf2fdd55f |
| institution | Directory Open Access Journal |
| issn | 2456-4869 |
| language | English |
| last_indexed | 2024-12-17T10:09:35Z |
| publishDate | 2021-06-01 |
| publisher | Thieme Medical Publishers, Inc. |
| record_format | Article |
| series | Journal of Clinical Interventional Radiology ISVIR |
| spelling | doaj.art-c8fad5aed0004004a6d3c7dcf2fdd55f2022-12-21T21:53:04ZengThieme Medical Publishers, Inc.Journal of Clinical Interventional Radiology ISVIR2456-48692021-06-01050317217610.1055/s-0041-1728977Management of Visceral Artery Pseudoaneurysms by Combined Technique of Percutaneous Thrombin Injection and Endovascular CoilingKalpana Sivalingam0Karthik Palanisamy1Amalan Ignatius2Barnard Institute of Radiology, Madras Medical College, Chennai, Tamil Nadu, IndiaBarnard Institute of Radiology, Madras Medical College, Chennai, Tamil Nadu, IndiaBarnard Institute of Radiology, Madras Medical College, Chennai, Tamil Nadu, IndiaPurpose To describe our initial experience with percutaneous thrombin injection combined with endovascular coiling of high-flow visceral artery pseudoaneurysms. Materials and Methods Institutional review board approval was obtained. Between January 2019 and February 2020, 21 patients with nonvariceal upper gastrointestinal (GI) bleed underwent multidetector CT angiography. Four patients with acute pancreatitis and large pseudoaneurysms were selected for the combined technique. Human thrombin reconstituted with calcium chloride was injected percutaneously. Partially thrombosed aneurysms were treated up to three times. Simultaneously or within 15 days, coil embolization of the neck or patent part of pseudoaneurysm was performed. Patients were followed up to 1 month postprocedure. Results The size of the pseudoaneurysms ranged from 3 cm to 6 cm. All were accessed percutaneously by 22G Chiba needle under ultrasound guidance and 500 to 1500 units of thrombin was injected in one to three attempts. Subsequently, endovascular coiling of the neck of the pseudoaneurysm or of the feeding artery was performed. Technical success with cessation of flow was achieved in all four patients. One patient developed obstructive jaundice postprocedure and another continued to have GI bleeding despite thrombin injection. Conclusion Percutaneous thrombin injection is an easy to use and effective tool for treating visceral artery pseudoaneurysms and can be combined with endovascular coiling for successful occlusion of large pseudoaneurysms.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1728977pseudoaneurysmsthrombincoiling |
| spellingShingle | Kalpana Sivalingam Karthik Palanisamy Amalan Ignatius Management of Visceral Artery Pseudoaneurysms by Combined Technique of Percutaneous Thrombin Injection and Endovascular Coiling Journal of Clinical Interventional Radiology ISVIR pseudoaneurysms thrombin coiling |
| title | Management of Visceral Artery Pseudoaneurysms by Combined Technique of Percutaneous Thrombin Injection and Endovascular Coiling |
| title_full | Management of Visceral Artery Pseudoaneurysms by Combined Technique of Percutaneous Thrombin Injection and Endovascular Coiling |
| title_fullStr | Management of Visceral Artery Pseudoaneurysms by Combined Technique of Percutaneous Thrombin Injection and Endovascular Coiling |
| title_full_unstemmed | Management of Visceral Artery Pseudoaneurysms by Combined Technique of Percutaneous Thrombin Injection and Endovascular Coiling |
| title_short | Management of Visceral Artery Pseudoaneurysms by Combined Technique of Percutaneous Thrombin Injection and Endovascular Coiling |
| title_sort | management of visceral artery pseudoaneurysms by combined technique of percutaneous thrombin injection and endovascular coiling |
| topic | pseudoaneurysms thrombin coiling |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1728977 |
| work_keys_str_mv | AT kalpanasivalingam managementofvisceralarterypseudoaneurysmsbycombinedtechniqueofpercutaneousthrombininjectionandendovascularcoiling AT karthikpalanisamy managementofvisceralarterypseudoaneurysmsbycombinedtechniqueofpercutaneousthrombininjectionandendovascularcoiling AT amalanignatius managementofvisceralarterypseudoaneurysmsbycombinedtechniqueofpercutaneousthrombininjectionandendovascularcoiling |