Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
권호 표지

Endovascular Thrombin Injection for a Pulmonary Artery Pseudoaneurysm: Case Report

폐동맥 가성동맥류에 대한 혈관내 트롬빈 주입 치료: 증례 보고

  • Sin, Jin-Ho (Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Sin, Ji-Hun (Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Yun, Hyeon-Gi (Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center)
  • 신진호 (울산대학교 의과대학 서울아산병원 영상의학과학교실) ;
  • 신지훈 (울산대학교 의과대학 서울아산병원 영상의학과학교실) ;
  • 윤현기 (울산대학교 의과대학 서울아산병원 영상의학과학교실)
  • Published : 2011.12.01
⟨ Previous Next ⟩

Abstract

Massive hemoptysis caused by pulmonary artery pseudoaneurysms is uncommon, and endovascular treatment such as coil embolization is the first choice for treating pulmonary artery pseudoaneurysms. Various embolic agents could be used according to the angiographic findings, yet embolization with thrombin injection is very rare. Herein, we describe a case of a pulmonary artery pseudoaneurysm that was successfully treated by endovascular thrombin injection using a microcatheter because of the difficulty in performing a coil embolization due to a short feeding artery.

대량 객혈을 일으킨 환자에서 원인으로 폐동맥 가성동맥류의 빈도는 드물며, 코일 색전술과 같은 경도관 색전술이 일차적인 치료 방법이다. 가성동맥류의 크기 및 해부학적 구조에 따라 다양한 색전 물질을 이용한 폐동맥 가성동맥류 치료의 보고가 있었으나 트롬빈 주입으로 치료한 예는 매우 드물다. 저자들은 폐동맥 가성동맥류의 치료에 있어서 짧은 영양동맥으로 인해 코일 색전술을 시행하기 어려운 경우 미세카테터를 이용한 혈관내 트롬빈 주입으로 폐동맥 가성동맥류를 성공적으로 치료하였기에 이를 보고하는 바이다.

Keywords

References

  1. Sbano H, Mitchell AW, Ind PW, Jackson JE. Peripheral pulmonary artery pseudoaneurysms and massive hemoptysis. AJR Am J Roentgenol 2005;184:1253-1259 https://doi.org/10.2214/ajr.184.4.01841253
  2. Hovis CL, Zeni PT Jr. Percutaneous thrombin injection of a pulmonary artery pseudoaneurysm refractory to coil embolization. J Vasc Interv Radiol 2006;17:1943-1946 https://doi.org/10.1097/01.RVI.0000250985.07237.FB
  3. Lee K, Shin T, Choi J, Kim Y. Percutaneous injection therapy for a peripheral pulmonary artery pseudoaneurysm after failed transcatheter coil embolization. Cardiovasc Intervent Radiol 2008;31:1038-1041 https://doi.org/10.1007/s00270-008-9310-z
  4. Schellhammer F, Steinhaus D, Cohnen M, Hoppe J, Modder U, Fürst G. Minimally invasive therapy of pseudoaneurysms of the trunk: application of thrombin. Cardiovasc Intervent Radiol 2008;31:535-541 https://doi.org/10.1007/s00270-007-9272-6
  5. Dobies DR, Cohoon AL, Bates AA. Images in cardiovascular medicine. Repair of a perforated pulmonary artery due to a Swan-Ganz catheter using thrombin injection. Circulation 2009;119:e521-e522 https://doi.org/10.1161/CIRCULATIONAHA.107.739482
  6. Cope C, Zeit R. Coagulation of aneurysms by direct percutaneous thrombin injection. AJR Am J Roentgenol 1986; 147:383-387 https://doi.org/10.2214/ajr.147.2.383
  7. Remy J, Lemaitre L, Lafitte JJ, Vilain MO, Saint Michel J, Steenhouwer F. Massive hemoptysis of pulmonary arterial origin: diagnosis and treatment. AJR Am J Roentgenol 1984;143:963-969 https://doi.org/10.2214/ajr.143.5.963
  8. Keeling AN, Costello R, Lee MJ. Rasmussen's aneurysm: a forgotten entity? Cardiovasc Intervent Radiol 2008;31: 196-200 https://doi.org/10.1007/s00270-007-9122-6
  9. Krueger K, Zaehringer M, Strohe D, Stuetzer H, Boecker J, Lackner K. Postcatheterization pseudoaneurysm: results of US-guided percutaneous thrombin injection in 240 patients. Radiology 2005;236:1104-1110 https://doi.org/10.1148/radiol.2363040736
  10. Vazquez V, Reus M, Pinero A, Abellan D, Canteras M, Espinosa de Rueda M, et al. Human thrombin for treatment of pseudoaneurysms: comparison of bovine and human thrombin sonogram-guided injection. AJR Am J Roentgenol 2005;184:1665-1671 https://doi.org/10.2214/ajr.184.5.01841665