Endovascular and Percutaneous Management of the Pseudoaneurysms

Introduction: Pseudoaneurysm is a dilatation of an artery with actual disruption of one or more layers of its wall, rather than just expansion of wall layers. Pseudoaneurysms are common vascular abnormalities. Computed Tomography (CT), Magnetic Resonance Imaging (MRI), sonography, and angiography all are valuable modalities in the imaging workup of pseudoaneurysms. Conventional angiography remains the gold standard for diagnosis. Therapeutic options have evolved in recent years from the traditional surgical option toward a less invasive approach which includes procedures such as Ultrasound (US)-guided compression, US-guided percutaneous thrombin injection, and endovascular management (embolization, stent-graft placement and endovascular coiling). Objective: In this article, we discuss pseudoaneurysms of various arteries, and available percutaneous and endovascular treatment options. Materials and Methods: Sixteen patients diagnosed with pseudoaneurysm involving visceral and peripheral arteries were included in this study. The initial diagnosis was made with CDUS, CECT, and CTA followed by catheter angiogram for therapeutic procedures. Results: All the 16 patients with pseudoaneurysms were successfully treated with endovascular and percutaneous embolization to achieve stasis. Conclusion: CT, MRI, sonography, and angiography may all be valuable in the imaging workup of pseudoaneurysms. The use of minimally invasive treatment has led to a marked decrease in the morbidity and mortality rates for pseudoaneurysms.