<b>Percutaneous Thrombin Injection of Carotid Artery Pseudoaneurysm</b>

Holder, Rebecca; Hilton, Derek; Martin, Janis; Harris, Peter L.; Rowlands, P. C.; McWilliams, Richard G.

doi:10.1583/1545-1550(2002)009<0025:ptioca>2.0.co;2

Cited by 25 publications

(9 citation statements)

References 11 publications

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“…Holder et al 8 treated the aneurysm solely by percutaneous injection of thrombin, without the prior use of covered stent grafts. In their case, this approach was successful.…”

Section: Discussionmentioning

confidence: 99%

Republished: A novel approach to the management of carotid blowout syndrome: the use of thrombin in a case of failed covered stenting

Sablani

Jain

Hasan

et al. 2016

J NeuroIntervent Surg

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Acute hemorrhage relating to an expanding pseudoaneurysm of the carotid artery is referred to as carotid blowout syndrome (CBS). CBS is associated with a high morbidity and mortality. We describe the case of a patient who presented with dysphagia and a pulsatile mass in the neck. Imaging revealed a pseudoaneurysm originating from the bifurcation of the distal right common carotid artery. On neuroangiography the patient lacked sufficient collaterals to allow for vessel sacrifice. A decision was made to use covered stents to prevent flow into the pseudoaneurysm while maintaining vessel patency. Despite placement of multiple covered stents there was residual slow filling of the pseudoaneurysm. We augmented this therapy with direct percutaneous thrombin injection into the pseudoaneurysm. This resulted in complete thrombosis of the pseudoaneurysm. For recalcitrant lesions in which the usual methods of stopping blood flow to the pseudoaneurysmal sac fail, an adjuvant approach with thrombin should be considered.

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“…Holder et al 8 treated the aneurysm solely by percutaneous injection of thrombin, without the prior use of covered stent grafts. In their case, this approach was successful.…”

Section: Discussionmentioning

confidence: 99%

Republished: A novel approach to the management of carotid blowout syndrome: the use of thrombin in a case of failed covered stenting

Sablani

Jain

Hasan

et al. 2016

J NeuroIntervent Surg

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“…2,9 This approach has been used for the treatment of pseudoaneurysms in various anatomic locations, including the upper and lower extremities, the thorax, the carotid artery, and postpancreatitis peripancreatic, retroperitoneal, and hepatic areas. 7,[11][12][13][14][15][16] Currently, surgical treatment is reserved for failures of this minimally invasive approach. 17 Despite the documented safety of pseudoaneurysm thrombin injections, this technique is not free of complications.…”

Section: Discussionmentioning

confidence: 99%

Lower extremity arterial thrombosis following sonographically guided thrombin injection of a femoral pseudoaneurysm

Stawicki

Hoey

2006

J of Clinical Ultrasound

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Sonographically guided percutaneous thrombin injection is a minimally invasive and highly successful treatment of arterial pseudoaneurysms. Despite a very low complication rate, several severe arterial thrombotic events have been reported following thrombin injection of pseudoaneurysms. Native arterial thrombosis, though recognized as a severe complication of thrombin injection, has not been well described in the literature. We report a case of successful surgical management of arterial thrombosis after percutaneous thrombin injection of a femoral artery pseudoaneurysm in a 69-year-old woman. The pathophysiology, risk factors, diagnosis, and treatment options for this complication are discussed.

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“…2,4 To reduce this risk, authors suggest that the tip of the needle should be imaged continuously, and the tip of the needle should be positioned in the superficial center of the pseudoaneurysm. 4,7 The literature suggests that injecting thrombin at the point where flow is most stagnant results in the creation of a large volume of thrombus, which will be greater than the aneurysm neck, therefore avoiding distal embolization. This assumption is based on the theory that injecting the thrombin in the superficial area of the pseudoaneurysm will cause the clot to develop superficially and then propagate toward the neck.…”

Section: Discussionmentioning

confidence: 99%

Radial Artery Pseudoaneurysm

Pozniak

Mitchell

Ledwidge

2005

Journal of Ultrasound in Medicine

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Percutaneous Thrombin Injection of Carotid Artery Pseudoaneurysm

Abstract: Percutaneous thrombin injection may be a new and successful method of treating carotid artery pseudoaneurysms.

Cited by 25 publications

References 11 publications

Republished: A novel approach to the management of carotid blowout syndrome: the use of thrombin in a case of failed covered stenting

Republished: A novel approach to the management of carotid blowout syndrome: the use of thrombin in a case of failed covered stenting

Lower extremity arterial thrombosis following sonographically guided thrombin injection of a femoral pseudoaneurysm

Radial Artery Pseudoaneurysm

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