A Case of Successful Treatment of Huge Pseudoaneurysm Complicated with Endovascular Intervention Using Thrombin Injection

Abstract

Iatrogenic femoral pseudoaneurysm (IPA) is a troublesome complication related to the femoral arterial access site used for invasive cardiovascular procedures. Several therapeutic strategies have been developed to treat this complication. They include surgical repair, ultrasound-guided compression repair, and minimally invasive percutaneous treatments (thrombin injection, coil embolization, and insertion of covered stents). Traditionally, surgical repair has been the main treatment for IPA, particularly when the size of the pseudoaneurysm is larger than 4 cm or when anticoagulation or GP-IIb/IIIa inhibitors are extensively used during the procedure. However, if the site of the pseudoaneurysm, such as deep femoral artery, was more deeply located, thrombin injection might be simpler or more useful compared to surgical ligation. Here, we report the successful treatment of huge IPA by percutaneous thrombin injection in a case complicated with giant pseudoaneurysm of deep femoral artery after the endovascular intervention for peripheral arterial occlusive disease.