Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content +++ Traumatic Pseudoaneurysms + • Arterial access for catheter procedures has risk of pseudoaneurysm formation• Pseudoaneurysms are arterial disruptions contained by fibrotic tissue• Most resolve spontaneously +++ Intra-Arterial Injections + • Seen among injecting drug abusers• Brachial and femoral most common• Vessel vasoconstriction results in thrombosis and distal ischemia +++ Epidemiology + • Percutaneous catheter-based procedures and anticoagulation: Increased frequency of pseudoaneurysms +++ Symptoms and Signs +++ Pseudoaneurysm + • Mass, may be pulsating• Bleeding• Pain +++ Intra-Arterial Injection + • Burning pain of limb• Gangrene of digits +++ Imaging Findings + • Duplex US can identify ongoing leak, patency of vessel + • Evaluate for distal ischemia or embolus + • Physical exam• Duplex US• Arteriography (rarely) +++ Pseudoaneurysms + • Most resolve spontaneously• US-guided compression can occlude the pseudoaneurysm leading to thrombosis and cure• Operative therapy, if indicated, includes primary repair of artery versus interposition graft +++ Intra-Arterial Injection + • If needle is still in place, irrigate with heparinized saline• Intra-arterial vasodilators to reduce spasm• Late complications, such as infection, treated by excision and ligation +++ Surgery +++ Indications + • Distal ischemia• Severe infection of pseudoaneurysm• Ongoing hemorrhage• Local integumentary/neurologic compromise +++ Complications + • Infection, pseudoaneurysm formation, chemical endarteritis late complications of intra-arterial injection +++ References ++Hye RJ. Compression therapy for acute iatrogenic femoral pseudoaneurysms. Semin Vasc Surg. 2000;13:58. [PubMed: 10743892] Your Access profile is currently affiliated with '[InstitutionA]' and is in the process of switching affiliations to '[InstitutionB]'. Please click ‘Continue’ to continue the affiliation switch, otherwise click ‘Cancel’ to cancel signing in. Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Password? Forgot Username? Sign in via OpenAthens Sign in via Shibboleth