Purpose: To report a patient in whom a posttraumatic pseudoaneurysm of the aortic arch was successfully treated by catheter-based delivery of thrombin with balloon occlusion of the entry tear.
Case report: A 63-year-old male presented with pseudoaneurysm of the aortic arch after blunt chest trauma which was detected incidentally during routine chest X-ray. Using a percutaneous transfemoral approach, a 5 French Swan-Ganz catheter could be positioned into the aneurysm sac. Under balloon occlusion of the entry tear in order to prevent systemic embolization, 1,000 units of bovine thrombin were injected into the aneurysm sac resulting in complete occlusion of the aneurysm. Contrast-enhanced computed tomographic control showed complete thrombosis of the aneurysm over a follow-up period of 12 months.
Conclusion: Percutaneous catheter-based delivery of thrombin is a feasible and effective minimally-invasive treatment alternative for patients with thoracic aortic pseudoaneurysms.
(c) 2007 Wiley-Liss, Inc.