Thrombin injection

Once detected, an aneurysm of the hepatic artery requires immediate treatment. Up to a certain size, intrahepatic aneurysms are treated by angiographic embolization. Coagulation by means of direct thrombin injection has also been described. (130) Larger aneurysms are treated by vascular surgery (ligation, vascular reconstruction, resection). (132, 137)... [Pg.837]

Cope, C., Zeit, R. Coagulation of aneurysms by direct percutaneous thrombin injection. Amer. J. Roentgenol. 1986 147 383 - 387... [Pg.841]

Percutaneous Ultrasound or CT Guided Embolization or Thrombin Injection 95... [Pg.87]

The author has used percutaneous CT guided thrombin injection in six patients where pancreatitis associated aneurysms could not be seen at selective angiography. The technique is relatively simple, the aneurysm being punctured with a 21-Gauge saline flushed needle under CT guidance... [Pg.95]

Initially human thrombin obtained from the blood transfusion service was used. However, although immediate thrombosis of the aneurysms was observed, recurrence occurred at follow up CECT (Fig. 7.10). This is not surprising in patients with on going pancreatitis. Repeat thrombin injections were required - in one case on three separate occasions. Though eventually permanent occlusion was obtained and the patients are still alive and well, subsequent patients were treated with autologous thrombin prepared from 50 cc of their own venous blood. This was done to avoid potential anaphylaxis. [Pg.96]

There is one further indication for thrombin occlusion of pancreatitis associated visceral aneurysms. Where the portal vein has occluded as a complication and the patient has a proximal splenic or gastroduodenal aneurysm, the proximal and distal coil embolization of which could compromise the hepatic arterial supply to the liver causing liver infarction, thrombin injection maybe a safer technique [29]. [Pg.96]

Puri S, Nicholson AA, Breen DJ (2003) Percutaneous thrombin injection for the treatment of a post-pancreatitis pseudoaneurysm. Eur Radiol 13 L79-L82... [Pg.98]

Armstrong EM, Edwards A, Kingsnorth AN et al (2003) Ultrasound guided thrombin injection to treat a pseudoaneurysm secondary to chronic pancreatitis. Eur J Vase Endovasc Surg 26 448-449... [Pg.98]

Ellis PK, Kennedy PT, Collins AJ, Blair PH (2003) The use of direct thrombin injection to treat a Type II endoleak following endovascular repair of abdominal aortic aneurysm. Cardiovasc Intervent Radiol 26 482-484... [Pg.252]

Gambaro E, Abou-Zamzam AM Jr, Teruya TH et al (2004) Ischemic colitis following translumbar thrombin injection for treatment of endoleak. Ann Vase Surg 18 74-78... [Pg.252]

Thrombin injection into the bronchial artery has been described, and has a theoretical advantage in patients where tortuosity of the target artery precludes superselective catheterization [45]. However, given the rather unpredictable behavior, and risk of peripheral embolization, this agent has not gained wide acceptance, the same as using absolute alcohol as an embolic agent. [Pg.274]

Vrachliotis T, Sheiman RG (2002) Treatment of massive hemoptysis with intraarterial thrombin injection of a bronchial artery. AJR Am J Roentgenol 179 113-114... [Pg.276]

They reported the successful direct needle-injection of thrombin to thrombose peripheral pseudoaneurysms such as common iliac, peroneal, and hepatic pseudoaneurysms. Despite this interesting report, it was not until a decade later that the first report of ultrasound-guided direct thrombin-injection to close iatrogenic groin pseudoaneurysms was published, by Liau et al. [16]. [Pg.71]

Variants of the above-described technique are also mentioned in the literature, but they are more complexandmore expensive andnolongerpromoted today. A technique of ultrasound-guided thrombin injection after transcatheter balloon occlusion of the neck of the pseudoaneurysm was promoted in the United Kingdom a few years ago [20,21] but this technique needs additional, contralateral puncture, contrast medium administration, and manipulation under X-ray guidance. Transcatheter injection... [Pg.73]

Immediate success defined as complete thrombosis of the pseudoaneurysmal cavity following thrombin injection is very high, and most series report an immediate success rate in between 90 and 100% (Table 6.2). Failure of percutaneous embolization can occur in multiloculated pseudoaneurysms, when one or more lobes are not punctured Sheiman et al. sought the predictors of failure [23]. They concluded that the volume of the pseudoaneurysm. [Pg.73]

Table 6.2. Overview of results of published series on percutaneous thrombin injection to treat iatrogenic postcatheterization pseudoaneurysms...

The simplicity and reproducibility of the procedure as well as the high efficacy and very low complication rate of percutaneous thrombin injection under ultrasound guidance have made it the treatment of choice for postcatheterization pseudoaneurysms in many institutions [19,26],... [Pg.74]

Fig. 6.4. Ultrasound of the groin, 90 days after thrombin injection reveals a small, residual hematoma (arrows), anterior to the femoral arteries...

Paulson EK, Nelson RC, Mayes CE, Sheafor DH, Sketch MH, Kliewer MA (2001) Sonographically guided thrombin injection of iatrogenic femoral pseudoaneurysms further experience of a single institution. AJR 177 309-316... [Pg.76]

Liau CS, Ho FM, Chen MF, Lee YT (1997) Treatment of iatrogenic femoral artery pseudoaneurysm with percutaneous thrombin injection. J Vase Surg 26 18-23... [Pg.76]

Pope M, Johnston KW (2000) Anaphylaxis after thrombin injection of a femoral pseudoaneurysm recommendations for prevention. J Vase Surg 32 190-191... [Pg.76]

Sheiman RG, Mastromatteo M (2003) Iatrogenic femoral pseudoaneurysms that are unresponsive to percutaneous thrombin injection potential causes. AJR 181 1301-1304... [Pg.78]

Kurz DJ, Jungius K-P, Luscher TF (2003) Delayed femoral vein thrombosis after ultrasound-guided thrombin injection of apostcatheterization pseudoaneurysm. J Vase Interv Radiol 14 1067-1070... [Pg.78]

Kang SS, Labropoulos N, Mansour MA, Baker WH (1998) Percutaneous ultrasound guided thrombin injection a new method for treating postcatheterization femoral pseudoaneurysms. J Vase Surg 27 1032-1038... [Pg.78]

Taylor BS, Rhee RY, Muluk S, Trachtenberg J, Walters D, Steed DL, Makaroun MS (1999) Thrombin injection versus compression of femoral artery pseudoaneurysms. J Vase Surg 30 1052-1059... [Pg.78]

La Perna L, Olin JW, Goines D, Childs MB, Ouriel K (2000) Ultrasound-guided thrombin injection for the treatment of postcatheterization pseudoaneurysms. Circulation 102 2391-1295... [Pg.78]

Brophy DP, Sheiman RG, Amatulle P, Akbari CM (2000) Iatrogenic femoral pseudoaneurysms thrombin injection after failed US-guided compression. Radiology 214 278-282... [Pg.78]

Friedman SG, Pellerito JS, Scher L, Faust G, Burke B, Safa T (2002) Ultrasound-guided thrombin injection is the treatment of choice for femoral pseudoaneurysms. Arch Surg... [Pg.78]

Extra-hepatic pseudoaneurysms are usually not treated with coil embolization since it would sacrifice a major branch to a lobe or even the entire liver. Successful percutaneous thrombin injection of an anastomotic pseudoaneurysm has been described [12]. Recently, a number of case reports have been published on the use of stent grafts to repair these... [Pg.89]

Kemmeter P, Bonnell B, VanderKolk W, Griggs T, van Erp J (2000) Percutaneous thrombin injection of splanchnic artery aneurysms two case reports. J Vase Interv Radiol 11 469-472... [Pg.94]

Patel JV, Weston MJ, Kessel DO, Prasad R, Toogood GJ, Robertson I (2003) Hepatic artery pseudoaneurysm after liver transplantation treatment with percutaneous thrombin injection. Transplantation 75 1755-1757... [Pg.94]

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