Balloon assisted, ultrasound guided percutaneous thrombin injection of a large radial artery pseudoaneurysm using a trans-venous approach via an Ipsilateral Arteriovenous Fistula

Abstract Background Pseudoaneurysm formation is known to complicate arteriovenous haemodialysis access. Ultrasound guided thrombin injection a recognised treatment option, but not possible in pseudoaneurysms with no measurable neck. Balloon assisted techniques have been described such cases, which transiently obstruct flow out of the pseudoaneurysm and thereby prevent non-target embolization during ultrasound percutaneous injection. We describe balloon technique for radial artery pseudoaneurysm, via retrograde access from draining cephalic vein an fistula. Method A 61-year-old male radio-cephalic fistula was found on duplex large neck, as well juxta-anastomotic stenosis. Endovascular selected over open surgery. Retrograde venous established, allowed concurrent both stenosis arterial pseudoaneurysm. After dilation stenosis, transluminal angioplasty catheter advanced across anastomosis inflated neck blood flow. This safe into by direct sac puncture; achieving thrombosis. Conclusions endovascular option that can obviate need surgery cases involving The single puncture. avoided its inherent complications.