Ultrasonic-Guided Percutaneous Injection of Pancreatic Pseudoaneurysm with Thrombin

Abstract

Pancreatic pseudoaneurysm is a relatively uncommon complication of chronic pancreatitis, with an associated high mortality if rupture or hemorrhage occurs. We present a case of pancreatic pseudoaneurysm complicating pancreatitis which was successfully treated by direct percutaneous injection of thrombin into the aneurysmal sac. Follow-up at 8 weeks did not demonstrate recurrence. This case indicates that percutaneous thrombin injection offers effective treatment of visceral arterial pseudoaneurysms.

Percutaneous Thrombin Embolization of a Ruptured Peripancreatic Pseudoaneurysm

“…Recently, there have been several case reports describing the effective treatment of peripancreatic pseudaneurysms by percutaneous injection of thrombin directly into the sac of the pseudoaneurysms [13,14,15,16,17]. In such cases, the procedure has generally been done under either CT or ultrasound guidance in stable patients with unruptured pseudoaneurysms.…”

Splenic artery pseudoaneurysm as a complication of pancreatic pseudocyst

“…In recent decades, pancreatic pseudocyst and complications which accompany it [1][2] have been successfully treated using conservative treatment without surgery [3][4][5] . There are clear adventages of new techniques development and modern achievements over the conventional surgical menagement, but only in clearly defined indications with acceptable risk of complications 6 .…”

Vascular Complications of Pancreatitis: Role of Interventional Therapy

“…This procedure has proved to be valuable in the treatment of iatrogenic false aneurysms involving femoral artery access sites, with a recurrence rate of 2% and a rate of distal embolization of 0.95% (19, 20). The effectiveness of this procedure in the treatment of visceral pseudoaneurysms is not well established; however, numerous case reports in the literature have documented the technique's efficacy (19-21). Sparrow et al (21) described a case of a 3 cm pancreatic head pseudoaneurysm that was successfully treated using ultrasound-guided thrombin injections due to their inability to catheterize the feeding vessel on angiography.…”