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Thrombin injection for failed stent graft repair of perforated atherosclerotic aortic ulcer.

We used direct thrombin injection to occlude a pseudoaneurysm that formed from a contained rupture of a penetrating atherosclerotic ulcer at the junction of the thoracic and abdominal aorta after we failed to seal the perforation with an endovascular stent graft. The principles of thrombin injection and the technical modifications specific for use in a false aneurysm of aortic origin are described. An evolving role for thrombin in endovascular therapy is suggested.