Ruptured arteriovenous fistula pseudoaneurysm treatment by balloon‐assisted direct percutaneous thrombin injection

2021 ◽  
Author(s):  
Luís Loureiro ◽  
Daniel Mendes ◽  
Clemente Neves Sousa ◽  
Paulo Almeida ◽  
António Norton de Matos ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Thrombin Injection ◽  
Percutaneous Thrombin Injection

scholarly journals Balloon Assisted, Ultrasound Guided Percutaneous Thrombin Injection of a Large Radial Artery Pseudoaneurysm Using a Trans-Venous Approach via an Ipsilateral Arteriovenous Fistula.

2021 ◽  
Author(s):  
Mark Gregory ◽  
Mike Guest ◽  
Islam Abdeen ◽  
Kate Steiner
Keyword(s):  
Endovascular Treatment ◽  
Arteriovenous Fistula ◽  
Radial Artery ◽  
Treatment Option ◽  
Open Surgery ◽  
Thrombin Injection ◽  
Ultrasound Guided ◽  
Concurrent Treatment ◽  
Artery Pseudoaneurysm ◽  
Percutaneous Thrombin Injection

Abstract Background: Pseudoaneurysm formation is known to complicate arteriovenous haemodialysis access. Ultrasound guided thrombin injection is a recognised treatment option, but is not possible in pseudoaneurysms with no measurable neck. Balloon assisted techniques have been described in such cases, which transiently obstruct flow out of the pseudoaneurysm and thereby prevent non-target embolization during ultrasound guided percutaneous thrombin injection. We describe a novel balloon assisted technique for the treatment of a radial artery pseudoaneurysm, via retrograde access from the draining cephalic vein of an arteriovenous fistula. Method: A 61 year old male with a radio-cephalic fistula was found on duplex ultrasound to have a large radial artery pseudoaneurysm with no measurable neck, as well as a juxta-anastomotic cephalic vein stenosis. Endovascular treatment was selected over open surgery. Retrograde cephalic venous access was established, which allowed for concurrent treatment of both the venous stenosis and the arterial pseudoaneurysm. After balloon dilation of the juxta-anastomotic stenosis, a percutaneous transluminal angioplasty balloon catheter was advanced across the arteriovenous anastomosis and inflated across the neck of the radial artery pseudoaneurysm, to transiently obstruct blood flow. This allowed for safe injection of thrombin into the pseudoaneurysm by direct ultrasound guided sac puncture; thereby achieving thrombosis. Conclusions: Balloon assisted ultrasound guided thrombin injection is an endovascular treatment option that can obviate the need for open surgery in cases involving pseudoaneurysms with no measurable neck. The novel technique described allowed both concurrent treatment of a juxta-anastomotic venous stenosis and treatment of an arterial pseudoaneurysm from a single venous puncture. This technique avoided arterial access and its inherent complications.

Balloon assisted, ultrasound guided percutaneous thrombin injection of a large radial artery pseudoaneurysm using a trans-venous approach via an Ipsilateral Arteriovenous Fistula

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Mark Gregory ◽  
Mike Guest ◽  
Islam Abdeen ◽  
Kate Steiner
Keyword(s):  
Endovascular Treatment ◽  
Arteriovenous Fistula ◽  
Radial Artery ◽  
Treatment Option ◽  
Open Surgery ◽  
Thrombin Injection ◽  
Ultrasound Guided ◽  
Concurrent Treatment ◽  
Artery Pseudoaneurysm ◽  
Percutaneous Thrombin Injection

Abstract Background Pseudoaneurysm formation is known to complicate arteriovenous haemodialysis access. Ultrasound guided thrombin injection is a recognised treatment option, but is not possible in pseudoaneurysms with no measurable neck. Balloon assisted techniques have been described in such cases, which transiently obstruct flow out of the pseudoaneurysm and thereby prevent non-target embolization during ultrasound guided percutaneous thrombin injection. We describe a balloon assisted technique for the treatment of a radial artery pseudoaneurysm, via retrograde access from the draining cephalic vein of an arteriovenous fistula. Method A 61-year-old male with a radio-cephalic fistula was found on duplex ultrasound to have a large radial artery pseudoaneurysm with no measurable neck, as well as a juxta-anastomotic cephalic vein stenosis. Endovascular treatment was selected over open surgery. Retrograde cephalic venous access was established, which allowed for concurrent treatment of both the venous stenosis and the arterial pseudoaneurysm. After balloon dilation of the juxta-anastomotic stenosis, a percutaneous transluminal angioplasty balloon catheter was advanced across the arteriovenous anastomosis and inflated across the neck of the radial artery pseudoaneurysm, to transiently obstruct blood flow. This allowed for safe injection of thrombin into the pseudoaneurysm by direct ultrasound guided sac puncture; thereby achieving thrombosis. Conclusions Balloon assisted ultrasound guided thrombin injection is an endovascular treatment option that can obviate the need for open surgery in cases involving pseudoaneurysms with no measurable neck. The technique described allowed both concurrent treatment of a juxta-anastomotic venous stenosis and treatment of an arterial pseudoaneurysm from a single venous puncture. This technique avoided arterial access and its inherent complications.

Percutaneous Thrombin Injection of Splanchnic Artery Aneurysms: Two Case Reports

2000 ◽  
Vol 11 (4) ◽  
pp. 469-472 ◽  
Author(s):  
Paul Kemmeter ◽  
Bruce Bonnell ◽  
Wayne VanderKolk ◽  
Thomas Griggs ◽  
Jeffrey VanErp
Keyword(s):  
Case Reports ◽  
Thrombin Injection ◽  
Percutaneous Thrombin Injection ◽  
Splanchnic Artery

Posttraumatic Lingual Artery Pseudoaneurysm Treated with Ultrasound-Guided Percutaneous Thrombin Injection

2014 ◽  
Vol 28 (5) ◽  
pp. 1317.e11-1317.e15
Author(s):  
Pamela C. Masella ◽  
Megan M. Hanson ◽  
Brian T. Hall ◽  
John J. Verghese ◽  
Dwight C. Kellicut
Keyword(s):  
Lingual Artery ◽  
Thrombin Injection ◽  
Ultrasound Guided ◽  
Artery Pseudoaneurysm ◽  
Percutaneous Thrombin Injection

scholarly journals Percutaneous Thrombin Injection for Treatment of a Hepatic Arterial Pseudoaneurysm after the Placement of a Transjugular Intrahepatic Portosystemic Shunt

2019 ◽  
Vol 9 ◽  
pp. 20 ◽  
Author(s):  
Daniel C. Oppenheimer ◽  
Luann Jones ◽  
Ashwani Sharma
Keyword(s):  
Portal Hypertension ◽  
Transjugular Intrahepatic Portosystemic Shunt ◽  
Portosystemic Shunt ◽  
Thrombin Injection ◽  
Portal Venous Flow ◽  
Venous Flow ◽  
Artery Pseudoaneurysm ◽  
Imaging Guidance ◽  
Intrahepatic Portosystemic Shunt ◽  
Percutaneous Thrombin Injection

Transjugular intrahepatic portosystemic shunt (TIPS) is a widely accepted option for treating the complications of portal hypertension. The procedure involves creating a communication between the portal and hepatic venous systems using imaging guidance, thereby diverting the portal venous flow and reducing the portosystemic gradient. However, as with any procedure, TIPS insertion is not without potential complications. We present a case of a 37-year-old female who developed a hepatic artery pseudoaneurysm following the placement of a TIPS which was successfully treated with percutaneous thrombin injection.

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