CT-Guided Percutaneous Thrombin Injection for Treatment of an Inferior Pancreaticoduodenal Artery Pseudoaneurysm

  • Marc Williams
  • Derek Alderson
  • Jim Virjee
  • Mark CallawayEmail author


We present a case of an inferior pancreaticoduodenal artery pseudoaneurysm treated by computed tomography (CT)-guided percutaneous injection of thrombin. As far as we are aware, we present the first documented case of successful long-term (9 months) follow-up with no evidence of recurrence.


Pseudoaneurysm Thrombin 


  1. 1.
    Cope C, Zeit R (1986) Coagulation of aneurysms by direct percutaneous thrombin. AJR Am J Roentgenol 147:383–387PubMedGoogle Scholar
  2. 2.
    Sparrow P, Asquith J, Chalmers N (2003) Ultrasonic-guided percutaneous injection of pancreatic pseudoaneurysm with thrombin. Cardiovasc Intervent Radiol 26:312–315PubMedCrossRefGoogle Scholar
  3. 3.
    Powell A, Benenati J, Becker G et al. (2002) Percutaneous ultrasound-guided injection for the treatment of pseudoaneurysms. J Am Coll Surg 194 [Suppl 1]:S53–57PubMedCrossRefGoogle Scholar
  4. 4.
    Luchs SG, Antonacci VP, Reid SK (1999) Pancreatic head pseudoaneurysm treated with percutaneous thrombin injection. AJR Am J Roentgenol 173:833–834Google Scholar
  5. 5.
    Friedman SG, Pellerito JS, Scher L et al. (2002) Ultrasound-guided thrombin injection is the treatment of choice of femoral pseudoaneurysms. Arch Surg 137:462–464PubMedCrossRefGoogle Scholar
  6. 6.
    Armstrong EM, Edwards A, Kingsnorth AN et al. (2003) Ultrasound-guided thrombin injection to treat a pseudoaneurysm secondary to chronic pancreatitis. Eur J Vasc Endovasc Surg 26:448–449PubMedCrossRefGoogle Scholar
  7. 7.
    Benjaminov O, Atri M (2002) Percutaneous thrombin injection for treatment of an intrarenal pseudoaneurysm. AJR Am J Roentgenol 178:364–366PubMedGoogle Scholar
  8. 8.
    Kemmeter P, Bonnell B, VanderKolk W et al. (2000) Percutaneous thrombin injection of splanchnic artery aneurysms: Two case reports. J Vasc Interv Radiol 11:469–472PubMedGoogle Scholar
  9. 9.
    El Hamel A, Parc R, Adda G et al. (1991) Bleeding pseudocyst and pseudoaneurysms in chronic pancreatitis. Br J Surg 78:1059–1063PubMedGoogle Scholar
  10. 10.
    Manazer JR, Monzon JR, Dietz PA et al. (2003) Treatment of pancreatic pseudoaneurysm with percutaneous transabdominal thrombin injection. J Vasc Surg 38:600–602PubMedCrossRefGoogle Scholar
  11. 11.
    Chan RP, David E (2004) Reperfusion of splanchnic artery aneurysm following transcatheter embolization: Treatment with percutaneous thrombin injection. Cardiovasc Intervent Radiol 27:264–267PubMedGoogle Scholar
  12. 12.
    Gadacz TR, Trunkey D, Kieffer RF (1978) Visceral vessel erosion associated with pancreatitis. Case reports and a review of the literature. Arch Surg 113:1438–1440PubMedGoogle Scholar
  13. 13.
    Coll DP, Ieradi R, Kerstein MD et al. (1998) Aneurysms of the pancreaticoduodenal arteries: A change in management. Ann Vasc Surg 12:286–291PubMedCrossRefGoogle Scholar
  14. 14.
    Appel N, Duncan JR, Schuerer DJ (2003) Percutaneous stent-graft treatment of superior mesenteric and internal iliac artery pseudoaneurysms. J Vasc Interv Radiol 1417–1422Google Scholar
  15. 15.
    Cowan S, Kahn MB, Bonn J et al. (2002) Superior mesenteric artery pseudoaneurysm successfully treated with polytetrafluoroethylene covered stent. J Vasc Surg 35:805–807PubMedCrossRefGoogle Scholar
  16. 16.
    Rocek M, Peregrin JH, Dutka J et al. (2002) Percutaneous treatment of a superior mesenteric artery pseudoaneurysm using a stent-graft. AJR Am J Roentgenol 178:1459–1461PubMedGoogle Scholar
  17. 17.
    Seriki DM, Abidia A, Butterfield JS, Ashleigh RJ, McCollum CN et al. (2004) Endovascular stent graft: Treatment of pseudoaneurysm of the superior mesenteric artery. Cardiovasc Intervent Radiol 27:271–273PubMedCrossRefGoogle Scholar
  18. 18.
    Ogino H, Banno T, Sato Y, Hara M, Shibamoto Y (2004) Superior mesenteric artery stent-graft placement in a patient with pseudoaneurysm developing from a pancreatic pseudocyst. Cardiovasc Intervent Radiol 27:68–70PubMedCrossRefGoogle Scholar
  19. 19.
    Hama Y, Kaji T, Iwasaki Y et al. (1999) Transcatheter embolization of a superior mesenteric artery pseudoaneurysm. A case report. Acta Radiol 40:649–651PubMedCrossRefGoogle Scholar
  20. 20.
    Criado E, Gasparis A (2004) Transluminal thrombin injection and exclusion of a paramesenteric abdominal aortic aneurysm. J Vasc Surg 39:1118–1121PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  • Marc Williams
    • 1
  • Derek Alderson
    • 2
  • Jim Virjee
    • 1
  • Mark Callaway
    • 1
    Email author
  1. 1.Department of SurgeryBristol Royal InfirmaryBristolUK
  2. 2.Department of Clinical RadiologyBristol Royal InfirmaryBristolUK

Personalised recommendations