During an abstract review, ("a novel approach to the management of carotid blowout syndrome: the use of thrombin in a case of failed stenting," journal of investigative medicine & volume 63, number 3, march 2015, authors: naveen sablani1, gary jain2, karthikeyan arcot1, jeffrey farkas) a method for treatment was described.As stated, "an (b)(6) male with a past medical history (pmh) significant for hypertension, coronary artery disease, abdominal aortic aneurysm and right carotid endarterectomy presented with dysphagia for 3 days with an expanding and painful pulsatile mass over his right neck.A computerized tomography angiogram of the neck showed a 6.8 x 6.1 x 4.5 cm expanding pseudo-aneurysm at the bulb of the right internal carotid artery (ica).Two gore viabahn® endoprosthesis were placed in the right ica with a significant decrease in flow to the pseudo-aneurysm sac(pas).Follow-up carotid doppler showed a significant increase in flow into the pas the next day.A third gore viabahn® endoprosthesis was placed to provide coverage at the site of the leak but filling into the pas continued.As an alternative approach, thrombin was injected percutaneously into the pas under fluoroscopy, with simultaneous balloon occlusion of the stent.".
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