Post-traumatic pseudoaneurysm of radial artery: Percutaneous treatment with thrombin injection

Abstract

Most peripheral pseudoaneurysms are iatrogen or, less commonly, post-traumatic. A post-traumatic pseudoaneurysm is a localized haematoma with a persistent communication with the native artery via a narrow neck. Pseudoaneurysms have typical findings such as a pulsatile palpable mass, a ‘‘yin/yang’’ sign on colour flow imaging and the typical ‘‘to and fro’’ sign on Doppler waveform analysis. Pseudoaneurysm can arise from the venous segments or from the artery. Venous pseudoaneurysms have a low complication rate, but arterial pseudoaneurysms have an unpredictable natural history and complications include expansion, rupture, arterial thrombosis and the radial steal syndrome. The diagnosis can be easily confirmed using colour duplex ultrasound. Ultrasound-guided manual compression is the usual method for the obliteration of a pseudoaneurysmbut it is often timeconsuming, uncomfortable for the patient and staff, and not always successful. Percutaneous ultrasound-guided thrombin injection has been reported for femoral artery pseudoaneurysms, the commonest site of iatrogenic trauma,