Arterial Pseudoaneurysm

Causes

The most common cause of arterial pseudoaneurysms is arterial puncture. This can occur from:

• Medical procedures such as cardiac catheterization, angioplasty, or insertion of an intravenous (IV) line
• Trauma, including blunt or penetrating injuries
• Weakened arterial walls due to infection or inflammatory conditions

Symptoms

Pseudoaneurysms may not cause any symptoms at first. However, as they grow larger, they can cause:

• Pulsating mass at the site of injury
• Pain in the affected area
• Bruising or discoloration over the pseudoaneurysm
• Numbness or weakness in the limb supplied by the affected artery (in some cases)

Diagnosis

If a pseudoaneurysm is suspected, your doctor will likely order one or more imaging tests to confirm the diagnosis and determine the size and location of the pseudoaneurysm. These tests may include:

• Ultrasound: This can be used to visualize the pseudoaneurysm and assess blood flow within it.
• CT scan: This can provide detailed images of the pseudoaneurysm and surrounding structures.
• MRI scan: This can be used to assess the extent of the injury and to identify any underlying conditions.
• Angiography: This is an X-ray imaging technique that uses a contrast dye to visualize the arteries. It can be helpful in diagnosing pseudoaneurysms in some cases.

Treatment

Treatment for an arterial pseudoaneurysm depends on the size, location, and symptoms it is causing. Some small pseudoaneurysms may not require treatment and can be monitored with regular imaging tests. However, most pseudoaneurysms require treatment to prevent rupture, which can be life-threatening. Treatment options include:

• Compression: In some cases, applying direct pressure to the pseudoaneurysm for a prolonged period can help to clot the blood within it and promote healing.
• Ultrasound-guided thrombin injection: This minimally invasive procedure involves injecting a clotting agent (thrombin) directly into the pseudoaneurysm to clot the blood and seal the leak.
• Surgical repair: This may be necessary for large or symptomatic pseudoaneurysms. The surgeon will remove the pseudoaneurysm and repair the damaged artery.
• Angioplasty and stenting: In some cases, a stent (a small expandable tube) can be placed in the artery to support the weakened wall and prevent the pseudoaneurysm from enlarging (Click here to read more on Angioplasty/stenting)

Complications

The most serious complication of an arterial pseudoaneurysm is rupture. If a pseudoaneurysm ruptures, it can cause severe bleeding, which can be life-threatening. Other potential complications include:

• Infection
• Nerve damage
• Compression of surrounding structures