Key result
Percutaneous ultrasound-guided human thrombin injection resolves type II endoleak from an internal iliac artery aneurysm.
Why the study?
Endoleak is the most common complication after endovascular abdominal aortic aneurysm repair, and managing slow-flow type II endoleaks when conventional access routes are occluded presents a clinical challenge.
Does direct percutaneous puncture and thrombin injection under ultrasound guidance effectively treat type II endoleak from an internal iliac artery aneurysm?
Case Report (n=1)
Does direct percutaneous puncture and thrombin injection under ultrasound guidance effectively treat type II endoleak from an internal iliac artery aneurysm?
Direct percutaneous puncture with ultrasound-guided thrombin injection may be a fast and safe alternative for treating type II endoleaks when standard endovascular access is blocked.
Recanalization via coiled iliac branches warrants vigilance in EVAR surveillance; extends the spectrum of type II endoleak interventions.
Endoleak it is the most common complication after endovascular abdominal aortic aneurysm repair and it represents the failure of endovascular treatment. In particular type 2 endoleak is associated with retrograde flow in the aneurysm sac from one or more arterial branches. We describe a reperfusion of the aortic aneurysm sac with slow-flow type II endoleak from the right internal iliac artery aneurysm through the posterior door previously closed with coils, and treatment with direct puncture of the internal iliac artery aneurysm with infixion of human thrombin under ultrasound guidance, not previously described in the literature. In this case the direct puncture of the aneurysm sac was the faster and safer way to treat this patient just because the back door was closed by coils and the entry by the iliac graft. Thrombin reduces significantly the presence of artifacts and give to us the exact extension of thrombosis into the aneurysm sac and the echo-guided offers the advantage of being able to monitor the progression of the thrombotic process induced by thrombin injection in real time.
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Giordano et al. (2019) conducted a case report in Type II endoleak from right internal iliac artery aneurysm (n=1). Direct percutaneous puncture and thrombin injection under ultrasound guidance was evaluated on Thrombosis of the aneurysm sac. Direct percutaneous puncture with ultrasound-guided human thrombin injection successfully treated a type II endoleak from an internal iliac artery aneurysm.
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