Percutaneous thrombin injection of carotid artery pseudoaneurysm.
OBJECTIVE
To report the successful treatment of a carotid artery pseudoaneurysm by percutaneous thrombin injection.


METHODS
A 71-year-old man with end-stage renal failure presented with acute left ventricular failure. The right common carotid artery (CCA) was punctured during attempted jugular line insertion, and he developed a large pseudoaneurysm connected to the CCA by a long, narrow neck. Ultrasound-guided compression was unsuccessful, so another technique was attempted. An occlusion balloon was inflated in the CCA at the neck of the aneurysm to avoid distal embolization, and 250 units of human thrombin were injected into the sac percutaneously; thrombosis was instantaneous. There were no procedural complications, and repeat ultrasound at 3 months showed resolution of the hematoma and no residual pseudoaneurysm. There were no neurological complications.


CONCLUSIONS
Percutaneous thrombin injection may be a new and successful method of treating carotid artery pseudoaneurysms.
Holder
Rebecca
R
Department of Radiology, Royal Liverpool University Hospital, England, UK.
Hilton
Derek
D
Martin
Janis
J
Harris
Peter L
PL
Rowlands
Peter C
PC
McWilliams
Richard G
RG
D000368:Aged; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000188:drug therapy*; D000792:Angiography; D020212:Carotid Artery Injuries; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000379:methods; D005500:Follow-Up Studies; D006333:Heart Failure / Q000150:complications / Q000175:diagnosis; D006801:Humans; D007049:Iatrogenic Disease; D007269:Injections, Intra-Arterial; D007676:Kidney Failure, Chronic / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D008297:Male; D013917:Thrombin / Q000008:administration & dosage*; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler
D013917:Thrombin