scholarly journals Management of Visceral Artery Pseudoaneurysms by Combined Technique of Percutaneous Thrombin Injection and Endovascular Coiling

2021 ◽  
Author(s):  
Kalpana Sivalingam ◽  
Karthik Palanisamy ◽  
Amalan Ignatius
Keyword(s):  
Multidetector Ct ◽  
Visceral Artery ◽  
Endovascular Coiling ◽  
Thrombin Injection ◽  
Institutional Review ◽  
Human Thrombin ◽  
Percutaneous Thrombin Injection ◽  
Gi Bleed ◽  
Combined Technique ◽  
Upper Gastrointestinal

Abstract 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.

Percutaneous Thrombin Injection of Carotid Artery Pseudoaneurysm

2002 ◽  
Vol 9 (1) ◽  
pp. 25-28 ◽  
Author(s):  
Rebecca Holder ◽  
Derek Hilton ◽  
Janis Martin ◽  
Peter L. Harris ◽  
Peter C. Rowlands ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Neurological Complications ◽  
Left Ventricular ◽  
Thrombin Injection ◽  
Artery Pseudoaneurysm ◽  
Occlusion Balloon ◽  
Human Thrombin ◽  
Percutaneous Thrombin Injection ◽  
The Right ◽  
End Stage

Purpose: To report the successful treatment of a carotid artery pseudoaneurysm by percutaneous thrombin injection. Case Report: A 71-year-old man with end-stage renal failure presented with acute left ventricular failure. The right common carotid artery (CCA) was punctured during attempted jugular line insertion, and he developed a large pseudoaneurysm connected to the CCA by a long, narrow neck. Ultrasound-guided compression was unsuccessful, so another technique was attempted. An occlusion balloon was inflated in the CCA at the neck of the aneurysm to avoid distal embolization, and 250 units of human thrombin were injected into the sac percutaneously; thrombosis was instantaneous. There were no procedural complications, and repeat ultrasound at 3 months showed resolution of the hematoma and no residual pseudoaneurysm. There were no neurological complications. Conclusions: Percutaneous thrombin injection may be a new and successful method of treating carotid artery pseudoaneurysms.

Percutaneous Thrombin Injection of Splanchnic Artery Aneurysms: Two Case Reports

2000 ◽  
Vol 11 (4) ◽  
pp. 469-472 ◽  
Author(s):  
Paul Kemmeter ◽  
Bruce Bonnell ◽  
Wayne VanderKolk ◽  
Thomas Griggs ◽  
Jeffrey VanErp
Keyword(s):  
Case Reports ◽  
Thrombin Injection ◽  
Percutaneous Thrombin Injection ◽  
Splanchnic Artery

Posttraumatic Lingual Artery Pseudoaneurysm Treated with Ultrasound-Guided Percutaneous Thrombin Injection

2014 ◽  
Vol 28 (5) ◽  
pp. 1317.e11-1317.e15
Author(s):  
Pamela C. Masella ◽  
Megan M. Hanson ◽  
Brian T. Hall ◽  
John J. Verghese ◽  
Dwight C. Kellicut
Keyword(s):  
Lingual Artery ◽  
Thrombin Injection ◽  
Ultrasound Guided ◽  
Artery Pseudoaneurysm ◽  
Percutaneous Thrombin Injection

scholarly journals Percutaneous Thrombin Injection for Treatment of a Hepatic Arterial Pseudoaneurysm after the Placement of a Transjugular Intrahepatic Portosystemic Shunt

2019 ◽  
Vol 9 ◽  
pp. 20 ◽  
Author(s):  
Daniel C. Oppenheimer ◽  
Luann Jones ◽  
Ashwani Sharma
Keyword(s):  
Portal Hypertension ◽  
Transjugular Intrahepatic Portosystemic Shunt ◽  
Portosystemic Shunt ◽  
Thrombin Injection ◽  
Portal Venous Flow ◽  
Venous Flow ◽  
Artery Pseudoaneurysm ◽  
Imaging Guidance ◽  
Intrahepatic Portosystemic Shunt ◽  
Percutaneous Thrombin Injection

Transjugular intrahepatic portosystemic shunt (TIPS) is a widely accepted option for treating the complications of portal hypertension. The procedure involves creating a communication between the portal and hepatic venous systems using imaging guidance, thereby diverting the portal venous flow and reducing the portosystemic gradient. However, as with any procedure, TIPS insertion is not without potential complications. We present a case of a 37-year-old female who developed a hepatic artery pseudoaneurysm following the placement of a TIPS which was successfully treated with percutaneous thrombin injection.

Abstract 15876: The Safety of Transesophageal Echocardiography in Patients With Gastroesophageal Varices

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Ziad Alnabki ◽  
Wasiq F Rawasia ◽  
Gerald Dryden ◽  
Ali Usmani ◽  
Marcus F Stoddard
Keyword(s):  
Esophageal Perforation ◽  
Bleeding Complications ◽  
Respiratory Compromise ◽  
Age And Gender ◽  
Gastroesophageal Varices ◽  
Reversal Agents ◽  
Grade 3 ◽  
And Gender ◽  
Gi Bleed ◽  
Upper Gastrointestinal

Introduction: The presence of gastroesophageal varices (GEV) is considered a relative contraindication to performing Trans esophageal echocardiography (TEE) however; the safety of TEE in patients with GEV is unknown. Hypothesis: Bleeding complications related to TEE in patients with GEV are dependent on the severity of the GEV. Methods: 55 patients (G1) with GEV undergoing clinically indicated TEE were studied. Each patient was matched by age and gender to a control subject (C). GEV were graded using esophagogastroduodenoscopy (EGD). There were 39 males and 16 females in either group. Complications related to TEE were defined as upper gastrointestinal (GI) bleed, decline in hemoglobin by more than 2 g/dl, esophageal perforation, aspiration, respiratory compromise requiring intubation and/or need for sedative reversal agents that occurred within 48 hours of the procedure. Results: In G1 grade 1, grade 2, and grade 3 GEV were present in 21, 24, and 12 patients, respectively. Of the 12 patients with grade 3 GEV, one patient had GI bleed. TEE findings included vegetation in 8 patients of G1 and in — patients of C and thrombus in 3 patients of G1 and 3 patients of C. Conclusions: TEE appears safe in patient with grade 1 or 2 GEV. However, caution should be advised when performing TEE in patients with grade 3 GEV. TEE showed significant findings of vegetation or thromus in at least 20% of the patients with GEV.

Upper GI Bleed, Etiology, Role of Endoscopy in Rural Population of Punjab

2010 ◽  
Vol 1 (3) ◽  
pp. 55-68 ◽  
Author(s):  
Ravinder Singh Malhotra ◽  
K. S. Ded ◽  
Arun Gupta ◽  
Darpan Bansal ◽  
Harneet Singh
Keyword(s):  
Peptic Ulcer ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Common Cause ◽  
Endoscopic Techniques ◽  
Gi Bleed ◽  
Upper Gastrointestinal ◽  
Common Variable ◽  
Important Progress

Haematemesis and malena are the two most important symptoms of upper gastrointestinal bleeding . The most common cause of upper gastrointestinal bleeding is due to a peptic ulcer. In this paper, the authors research the cause of bleeding. Contrary to previous studies, results favor esophageal varices, e.g., alcoholism or cirrhosis liver post necrotic, as the most common cause of bleeding rather than a peptic ulcer. The authors’ study is based on an observational retrospective protocol with records of 50 consecutive patients with GI bleeding, attending the emergency room from February 2007 until September 2009. Results show that the treatment of UGI bleeding has made important progress since the introduction of emergency endoscopy and endoscopic techniques for haemostasis. The application of specific protocols significantly decreases rebleeding and the need for surgery, whereas mortality is still high. The data highlight the decreasing trend of peptic ulcer as the sole cause of bleeding, as shown in previous literature, ascertaining that varices are now the most common variable.

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