Percutaneous Ultrasound Guided Thrombin Injection for Endoleaks: An Alternative

Endoleaks are now well-recognized complications of endovascular repair of abdominal aortic aneurysm and an incidence of up to 46% has been reported in the literature. These endoleaks can result in rupture of the aneurysmal sac with potentially serious consequences. A type 2 endoleak is the most common type with a feeding vessel reperfusing the aneurysm sac. Radiological treatment of such an endoleak usually involves coil or particle angioembolisation, but sometimes this can be difficult, especially if endovascular access to the feeding vessel is not straightforward. We describe and illustrate percutaneous ultrasound-guided thrombin injection in the treatment of a type 2 endoleak. In appropriate patients, this technique is simple to perform, and has low associated morbidity.