CC BY-NC-ND 4.0 · The Arab Journal of Interventional Radiology 2018; 02(03): S5
DOI: 10.1055/s-0041-1730659
Abstract

Treatment of Iatrogenic Peripheral Pseudoaneurysms

Saurabh Anant Joshi
Lokmanya Tilak Municipal Medical College, Mumbai, India
,
Vivek Ukirde
Lokmanya Tilak Municipal Medical College, Mumbai, India
,
Ashank Bansal
Lokmanya Tilak Municipal Medical College, Mumbai, India
,
Ajit Patil
Lokmanya Tilak Municipal Medical College, Mumbai, India
,
Abhijit Soni
Lokmanya Tilak Municipal Medical College, Mumbai, India
,
Maunil Bhuta
Lokmanya Tilak Municipal Medical College, Mumbai, India
› Author Affiliations

Background: Pseudoaneurysms are known complications of few invasive procedures, puncture site aneurysm after angiography, postjoint replacement surgery, etc. They are amenable to less invasive endovascular management, compared to open surgical approach. We present a series of 14 cases of pseudoaneurysms treated in our institute. Methods: Fourteen iatrogenic pseudoaneurysms were referred to our department in the past 2 years. Ten were postangiography arising from common or superficial femoral artery, two were postjoint replacement surgery, one in popliteal and femoral artery each, and 2 were involving brachial arteries, in dialysis patients in which artery was punctured in place of fistula vein. After initial ultrasonographic evaluation, sonography-guided compression was attempted in all. Four responded and 10 patients needed endovascular intervention. In one patient, pseudoaneurysm was arising from a branch of profunda femoris artery which was embolized using glue and coils. In remaining nine patients, the rent was in a major artery. In seven patients, balloon was kept in artery across the neck of pseudoaneurysm to occlude the flow in the pseudoaneurysm and percutaneous thrombin was injected. In one patient, complete thrombosis was not achieved by this treatment. In remaining two patients and in one who did not respond to percutaneous thrombin, a stent graft was deployed across the rent in the artery to close off the pseudoaneurysm. Results: All 14 patients were successfully treated, 4 by ultrasonography-guided compression and 10 by endovascular intervention. Balloon occlusion with percutaneous thrombin was done in seven patients and was adequate for six patients. Embolization with glue and coils was done in one patient in which the pseudoaneurysm was from a small branch. Three patients needed placement of stent graft. Conclusion: Interventional radiology offers various methods to successfully treat iatrogenic pseudoaneurysms in completely noninvasive or minimally invasive ways.



Publication History

Article published online:
11 May 2021

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