OJRad  Vol.4 No.3 , September 2014
Endovascular and Percutaneous Management of the Pseudoaneurysms
Abstract: 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.
Cite this paper: Chandradev, S. and Ateesh, S. (2014) Endovascular and Percutaneous Management of the Pseudoaneurysms. Open Journal of Radiology, 4, 241-254. doi: 10.4236/ojrad.2014.43032.


[2]   Saad, N.E.A., Saad, W.E.A., Davies, M.G., David, L., Fultz, W.P.J. and Rubens, D.J. (2005) Pseudoaneurysms and the Role of Minimally Invasive Techniques in Their Management. RadioGraphics, 25, S173-S189.

[3]   Soyer, P., Desgrippes, A., Vallee, J.N. and Rymer, R. (2000) Intrarenal Pseudoaneurysm after Percutaneous Nephrostolithotomy: Endovascular Treatment with N Butyl-2-Cyanoacrylate. European Radiology, 10, 1358.

[4]   Sansonna, F., Boati, S., Sguinzi, R., Migliorisi, C., Pugliese, F. and Pugliese, R. (2011) Severe Hemobilia from Hepatic Artery Pseudoaneurysm. Case Reports in Gastrointestinal Medicine, 2011, Article ID: 925142.

[5]   Singh, C.S., Giri, K., Gupta, R., Aladdin, Md. and Sawhney, H. (2006) Successful Management of Hepatic Artery Pseudoaneurysm Complicating Chronic Pancreatitis by Stenting. World Journal of Gastroenterology, 12, 5733-5734.

[6]   Lazinski, D., Willinsky, R.A., TerBrugge, K. and Montanera, W. (2000) Dissecting Aneurysms of the Posterior Cerebral Artery: Angioarchitecture and a Review of the Literature. Interventional Neuroradiology, 42, 128-133.

[7]   Taqi, Md., Lazzaro, M.A., Pandya, D.J., Badruddin, A. and Zaidat, O. (2011) Dissecting Aneurysms of Posterior Cerebral Artery: Clinical Presentation, Angiographic Findings, Treatment, and Outcome. Frontiers in Neurology Endovascular and Interventional Neurology, 2, 38.

[8]   Miley, J.T., Rodriguez, G.J. and Qureshi, A.I. (2008) Traumatic Intracranial Aneurysm Formation Following Closed Head Injury. Journal of Vascular and Interventional Neurology, 1, 79-82.

[9]   Matouk, C.C., Kaderali, Z., terBugge, K.G. and Willinsky, R.A. (2012) Willinsky Long-Term Clinical and Imaging Follow-Up of Complex Intracranial Aneurysms Treated by Endovascular Parent Vessel Occlusion. American Journal of Neuroradiology, 33, 1991-1997.

[10]   Yetkin, U. and Gurbuz, A. (2003) Post-Traumatic Pseudoaneurysm of the Brachial Artery and Its Surgical Treatment. Texas Heart Institute Journal, 30, 293-297.

[11]   Hajarizadeh, H., LaRosa, C.R., Cardullo, P., Rohrer, M.J. and Cutler, B.S. (1995) Worcester Mass Ultrasound-Guided Compression of Iatrogenic Femoral Pseudoaneurysm Failure, Recurrence, and Long-Term Results. Journal of Vascular Surgery, 22, 425-433.

[12]   Agrawal, G.A., Johnson, P.T. and Fishman, E. (2007) Splenic Artery Aneurysms and Pseudoaneurysms: Clinical Distinctions and CT Appearances. AJR, 188, 992-999.

[13]   Madoff, D.C., Denys, A., Wallace, M.J., Murthy, R., Gupta, S., Pillsbury, E.P., Ahrar, B.A.K., Bessoud, B. and Hicks, M.E. (2005) Splenic Arterial Interventions: Anatomy, Indications, Technical Considerations, and Potential Complications. RadioGraphics, 25, S191-S211.

[14]   Taori, K., Rathod, J., Disawal, A., Mundhada, M., Rewatkar, A., Bakare, V., Wavare, P. and Puria, R. (2013) Endovascular Embolization of Pseudoaneurysms Complicating Pancreatitis Using Microcoils: Case Series. Open Journal of Radiology, 3, 33-40.

[15]   Koren, M., Kinova, S., Bedeova, J., Javorka, V., Kovacova, E. and Kekenak, L. (2008) Hemosuccus Pancreatitis. Bratislavské Lekárske Listy, 109, 37-41.

[16]   Chong, W.W., Tan, S.G. and Htoo, M.M. (2008) Endovascular Treatment of Gastroduodenal Artery Aneurysm. Asian Cardiovascular & Thoracic Annals, 16, 68-72.

[17]   Germiller, J.A., Myers, L.L., Harris, M.O. and Bradford, C.R. (2001) Pseudoaneurysm of the Proximal Facial Artery Presenting as Oropharyngeal Hemorrhage. Head & Neck, 23, 259-263.<259::AID-HED1027>3.0.CO;2-4

[18]   Nanjundan, P., Rohilla, M., Raveendran, A., Jain, V. and Khandelwal, N. (2011) Pseudoaneurysm of Uterine Artery: A Rare Cause of Secondary Postpartum Hemorrhage, Managed with Uterine Artery Embolisation. Journal of Clinical Imaging Science, 1, 14.