title: Percutaneous thrombin embolization of a pancreatico-duodenal artery pseudoaneurysm after failing of the endovascular treatment.
abstract: Pancreatico-duodenal artery (PDA) pseudoaneurysms are rare vascular conditions with high mortality rates after rupture and they are frequently secondary to pancreatitis, surgery, trauma or infection. Due to the high risk of rupture and bleeding, it is mandatory to treat all pseudoaneurysms, regardless of their size or symptomatology. First option of treatment is open surgical repair, but it has high mortality rate, especially in hemodynamically unstable patients. In the recent years, percutaneous ultrasonography (US)- or computed tomography-guided thrombin injection was proposed as an alternative method for treating visceral aneurysms and pseudoaneurysms, but few reports described this therapy in case of peri-pancreatic pseudoaneurysms. We present a rare case of pseudoaneurysm of the PDA in a patient with no previous history of pancreatitis nor major surgery but with an occlusive lesion of the celiac axis. To the best of our knowledge this is the first reported case of PDA pseudoaneurysm successfully treated in emergency by single transabdominal US-guided injection of thrombin after failed attempts of percutaneous catheterization of the feeding vessel of the pseudoaneurysm.
authors.affiliation: Giulio Barbiero, Michele Battistel, Ana Susac, Diego Miotto, University Radiology, Department of Medicine, University Hospital of Padua, 35128 Padova, Italy.
authors.forename: Giulio
authors.initials: G
authors.lastname: Barbiero
authors.affiliation: Giulio Barbiero, Michele Battistel, Ana Susac, Diego Miotto, University Radiology, Department of Medicine, University Hospital of Padua, 35128 Padova, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Battistel
authors.affiliation: Giulio Barbiero, Michele Battistel, Ana Susac, Diego Miotto, University Radiology, Department of Medicine, University Hospital of Padua, 35128 Padova, Italy.
authors.forename: Ana
authors.initials: A
authors.lastname: Susac
authors.affiliation: Giulio Barbiero, Michele Battistel, Ana Susac, Diego Miotto, University Radiology, Department of Medicine, University Hospital of Padua, 35128 Padova, Italy.
authors.forename: Diego
authors.initials: D
authors.lastname: Miotto
keywords: Arterial intervention; Endovascular treatment; Pancreatico-duodenal artery; Percutaneous thrombin injection; Pseudoaneurysm embolization