title: Minimally invasive application of thrombin in the treatment of pseudoaneurysms following open aortic surgery.
abstract: BACKGROUND
  Anastomotic leaks are uncommon complications following aortic surgery. To avoid the morbidity associated with a second surgical procedure, minimally invasive techniques have become increasingly popular.
  
  
  OBJECTIVE
  To evaluate the feasibility and safety of thrombin in interventional treatment of postoperative pseudoaneurysms.
  
  
  METHODS
  CT-guided percutaneous injection was chosen in four cases. Endovascular access using an occlusion balloon catheter placed in the orifice of the pseudoaneurysm was utilized in one case.
  
  
  RESULTS
  The average volume of all pseudoaneurysms was 178 ± 190 mL with a volume of the patent lumen of 25 ± 28 mL. All aneurysms thrombosed after injection of 600 ± 237 IU of thrombin. During the follow-up period of an average of 10 months all pseudoaneurysms remained occluded.
  
  
  CONCLUSIONS
  Our series demonstrates the feasibility of thrombin in the treatment of aortic anastomotic pseudoaneurysms. In combination with occlusion balloon catheters, even wide-necked pseudoaneurysms may be treated successfully. However, further investigations are warranted.
authors.affiliation: Gemeinschaftskrankenhaus, Department of Radiology, Herdecke, Germany. f.schellhammer@gemeinschaftskrankenhaus.de
authors.forename: Frank
authors.initials: F
authors.lastname: Schellhammer
authors.forename: Mathias
authors.initials: M
authors.lastname: Cohnen
authors.forename: Günter
authors.initials: G
authors.lastname: Fürst
authors.forename: Ullrich
authors.initials: U
authors.lastname: Mödder
mesh_terms: D000368:Aged; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000601:surgery*; D001011:Aorta / Q000601:surgery*; D021721:Balloon Occlusion; D003287:Contrast Media; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D007479:Iopamidol / Q000031:analogs & derivatives; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000628:therapy; D011856:Radiographic Image Enhancement / Q000379:methods; D013917:Thrombin / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures
chemical_list: D003287:Contrast Media; D006490:Hemostatics; C057937:iomeprol; D013917:Thrombin; D007479:Iopamidol