Utility of percutaneous thrombin injection for treating visceral pseudoaneurysms. Issue 3 (1st June 2021)

• Record Type: Journal Article
• Authors: Gorsi, Ujjwal; Agarwal, Vivek; Yaser, Mohamed; Kalra, Naveen; Chaluvashetty, Shreedhara; Kang, Mandeep; Lal, Anupam; Sandhu, MS
• Is Part Of: Minimally invasive therapy & allied technologies. Volume 30:Issue 3(2021)
• Page Start: 174
• Page End: 178
• Publication Date: 2021-06-01
• Subjects: Pseudoaneurysm -- percutaneous -- thrombin; Endoscopy -- Periodicals; Interventional radiology -- Periodicals; Endoscopic surgery -- Periodicals; 617.05
• DOI: 10.1080/13645706.2020.1720251
• Languages: English
• ISSNs: 1364-5706

Abstract

Abstract: Purpose: To assess the efficacy and outcome of percutaneous thrombin injection in treatment of visceral arterial pseudoaneurysms (PAs) in a selective group of patients. Material and methods: Retrospective review of the institutional database showed 19 cases of visceral arterial pseudoaneurysms that were treated with percutaneous ultrasound-guided thrombin injection between January 2014 and December 2019 (13 men and 6 women). Of the pseudoaneurysms, 36% were due to pancreatitis, 35% were iatrogenic, 21% were infective and 8% traumatic. Most of the pseudoaneurysms arose from the hepatic artery (27%) followed by the splenic artery (26%) and renal artery (21%). Mean sac size of the pseudoaneurysms was 23 mm (range, 8 –40 mm). Technical success was defined as absence of flow within the PAs on follow-up ultrasonography (USG) 24 h and 3 days after thrombin injection. Results: Overall technical success was seen in 10/19 patients. Technical success of thrombin injection was higher in cases of distal branch PAs as compared to main vessel PAs (9/13 vs. 1/6). Success rates were higher with smaller (<23mm) pseudoaneurysms (7/12) as compared to larger ones (3/7). There were no procedure-related complications. Conclusion: Ultrasound-guided percutaneous thrombin injection is a novel method of treating visceral pseudoaneurysms as a painless, cheap and radiation-free procedure. However, further large-scale studies are needed to prove the efficacy in treating visceral pseudoaneurysms