Journal List > J Korean Soc Radiol > v.70(5) > 1087389

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Lee, Jeon, Hong, Cho, and Kim: Balloon-Assisted Ultrasound-Guided Thrombin Injection of a Pseudoaneurysm in the Posterior Tibial Artery: A Case Report
Cardiovascular Radiology

Journal of the Korean Society of Radiology 2014; 70(5): 325-329.

Published online: 8 May 2014

DOI: https://doi.org/10.3348/jksr.2014.70.5.325

Balloon-Assisted Ultrasound-Guided Thrombin Injection of a Pseudoaneurysm in the Posterior Tibial Artery: A Case Report

Taeg Ki Lee, MD1, Yong Sun Jeon, MD1, Kee Chun Hong, MD2, Soon Gu Cho, MD1, Eugene Kim, MD1

1Department of Radiology, Inha University School of Medicine, Incheon, Korea.

2Department of Surgery, Inha University School of Medicine, Incheon, Korea.

Corresponding author: Yong Sun Jeon, MD. Department of Radiology, Inha University Hospital, Inha University School of Medicine, 27 Inhang-ro, Jung-gu, Incheon 400-711, Korea. Tel. 82-32-890-2769, Fax. 82-32-890-2743, radjeon@inha.ac.kr

Received 8 January 2014       Accepted 3 March 2014

Copyright © 2014 The Korean Society of Radiology

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

An ultrasound-guided direct injection of thrombin is currently the first choice of treatment for the postcatheterization pseudoaneurysm, mainly in the femoral artery. A pseudoaneurysm in the posterior tibial artery is very rare, so there are not enough reports about proper treatment yet. We report a case of a balloon-assisted injection of thrombin under ultrasonography-guidance to manage a pseudoaneurysm in the posterior tibial artery and concurrently to prevent a distal artery embolization.

Keywords: Pseudoaneurysm, Posterior Tibial Artery, Balloon, Thrombin Injection

Figures and Tables

Fig. 1
Angiogram shows contrast outpouching lesion (arrow), consistent with pseudoaneurysm in distal right posterior tibial artery.
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Fig. 2
Color Doppler ultrasound shows typical swirling mosaic pattern of color flow (arrow) in pseudoaneurysm sac.
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Fig. 3
21-G Chiba needle (arrow) was inserted in the pseudoaneurysm under ultrasound guidance after occlusion of flow with 2.5 mm balloon (arrowhead).
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Fig. 4
Color Doppler ultrasound shows disappearance of abnormal color flow and the thrombus completely filling the pseudoaneurysm.
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Fig. 5
Immediate postprocedure angiogram shows disappearance of pseudoaneurysm in distal right posterior tibial artery.
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Fig. 6
Color Doppler ultrasound in logitudinal axis shows good arterial flow without pseudoaneurysm or hematoma after 3 months.
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Notes

This paper was supported by Inha University research grant.

References

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