CT-Guided Percutaneous Thrombin Injection of Posttraumatic Aortic Branch Pseudoaneurysm

Abstract

A pseudoaneurysm of an aortic branch artery is a potentially life-threatening uncommon occurrence, which may result in retroperitoneal hemorrhage. Imaging-guided percutaneous thrombin injection has a high technical success and effectiveness rate for treating pseudoaneurysms of the femoral, iliac, and popliteal arteries. We present a case of a retroperitoneal hemorrhage in a patient with a periaortic branch pseudoaneurysm, potentially from an avulsed lumbar artery. Anatomy prevented fixation with a covered stent; the comorbidities eliminated safe surgical repair, and endovascular embolization was not an option due to the avulsion. Computed tomography (CT) fluoroscopy-guided thrombin injection provided a safe, successful embolization with no postprocedural complications.

Keywords

• aortic branch pseudoaneurysm
• lumbar artery pseudoaneurysm
• CT-guided thrombin injection