In this report we present a case of a ruptured celiac artery aneurysm (CAA) with a thrombosed distal neck, which was treated as an emergently with a deployment of a tube thoracic endograft to the descending thoracic and upper abdominal aorta. The initial treatment was assisted with a second stage percutaneous, transhepatic, ultrasound guided needle infusion of coil and thrombin to the aneurysmal sac due to type Ib endoleak, with immediate thrombosis of the aneurysm. This technique, although not standard, could also be considered as a useful choice for the treatment of CAAs with wide proximal and patent distal neck.
ShanleyCJShahNLMessinaLM. Uncommon splanchnic artery aneurysms: pancreaticoduodenal, gastroduodenal, superior mesenteric, inferior mesenteric, and colic. Ann Vasc Surg1996;10:506–15
8.
WagnerWHAllinsADTreimanRLRuptured visceral artery aneurysms. Ann Vasc Surg1997;11:342–7
9.
TulsyanNKashyapVSGreenbergRKThe endovascular management of visceral artery aneurysms and pseudoaneurysms. J Vasc Surg2007;45:276–83
10.
GabelmannAGörichJMerkleEM. Endovascular treatment of visceral artery aneurysms. J Endovasc Ther2002;9:38–47
11.
WaldenbergerPBendixNPetersenJClinical outcome of endovascular therapeutic occlusion of the celiac artery. J Vasc Surg2007;46:655–61
12.
GabelmannAKramerSCTomczakRPercutaneous techniques for managing maldeployed or migrated stents. J Endovasc Ther2001;8:291–302
13.
SlonimSMDakeMDRazaviMKManagement of misplaced or migrated endovascular stents. J Vasc Intervent Radiol1999;10:851–9
14.
LaganàDCarrafielloGManginiMMultimodal approach to endovascular treatment of visceral artery aneurysms and pseudoaneurysms. Eur J Radiol2006;59:104–11
15.
SzopińskiPCiostekPPlebanEPercutaneous thrombin injection to complete SMA pseudoaneurysm exclusion after failing of endograft placement. Cardiovasc Intervent Radiol2005;28:509–14
16.
SparrowPAsquithJChalmersN. Ultrasonic-guided percutaneous injection of pancreatic pseudoaneurysm with thrombin. Cardiovasc Intervent Radiol2003;26:312–5
17.
OechsleSVollertKBueckleinWPercutaneous treatment of a ruptured superior mesenteric artery aneurysm in a child. Pediatr Radiol2006;36:268–71
18.
KemmeterPBonnellBVanderKolkWPercutaneous thrombin injection of splanchnic artery aneurysms: two case reports. J Vasc Intervent Radiol2000;11:469–72
19.
McIntyreTPSimoneSTStahlfeldKR. Intraoperative thrombin occlusion of a visceral artery aneurysm. J Vasc Surg2002;36:393–5
20.
GambaroEAbou-ZamzamAMJrTeruyaTHIschemic colitis following translumbar thrombin injection for treatment of endoleak. Ann Vasc Surg2004;18:74–8
21.
BushRLLinPHRonsonRSColonic necrosis subsequent to catheter-directed thrombin embolization of the inferior mesenteric artery via the superior mesenteric artery: a complication in the management of a type II endoleak. J Vasc Surg2001;34:1119–22
22.
OhlowMASecknusMAvon KornHPercutaneous thrombin injection for treatment of iatrogenic femoral artery pseudoaneurysms: a case for caution. Angiology2008;59:372–5
23.
HansonJMAtriMPowerN. Ultrasound-guided thrombin injection of iatrogenic groin pseudoaneurysm: Doppler features and technical tips. Br J Radiol2008;81:154–63
24.
TaylorBSRheeRYMulukSThrombin injection versus compression of femoral artery pseudoaneurysms. J Vasc Surg1999;30:1052–9
25.
PopeMJohnstonK. Anaphylaxis after thrombin injection of a femoral pseudoaneurysm: recommendation for prevention. J Vasc Surg2000;32:190–1