Percutaneous direct thrombin injection with hydrodissection to manage type II endoleak after endovascular abdominal aortic aneurysm repair

Figures

• 

  Figure 1. Axial computed tomography in prone position – endoleak type 2 right-sided to the endograft (EL – endoleak, Ur – ureter, VCI – vena cava inferior)

• 

  Figure 2. A) Needle advanced close to vena cava inferior and the ureter – the space between the structures sufficiently splayed with an injection of 5% glucose in water (Glu – glucose in water, Ur – ureter, VCI – vena cava inferior). B) Needle tip in the endoleak zone, shortly before thrombin injection

• 

  Figure 3. Control computed tomography after thrombin injection and needle removal- no persistent endoleak, no haemorrhagic complications, and no ureter injury

• 

  Figure 4. Follow-up contrast-enhanced ultrasound at six months – stentgraft patent (PG), no endoleak visible