A novel minimally invasive method of successful tissue glue injection in patients with iatrogenic pseudoaneurysm.

OBJECTIVE: To investigate the efficacy and safety of ultrasound-guided tissue glue injection for the treatment of iatrogenic femoral artery pseudoaneurysm.

METHODS: The study comprised of nine patients with unsuccessful ultrasound-guided thrombin injection and one patient with rapidly progressing anemia. All patients had undergone recanalization procedures at least twice, including two subjects with a very rapidly enlarging pseudoaneurysm lobe or significant anemia. Tissue glue at a dose of 0.9 ± 0.53 ml was injected under ultrasound guidance in each patient.

RESULTS: Complete embolization was achieved in all patients. Follow-up ultrasound performed 24 h later as well as at 1 and 2 weeks did not show recurrent reperfusion of the pseudoaneurysm.

CONCLUSION: Embolization of iatrogenic pseudoaneurysm using tissue glue seems to be an effective technique for the treatment of this complication. It might be considered as a treatment option in case of unsuccessful primary repair by means of thrombin injection orhemorrhagic shock due to rapid aneurysm progression. Advances in knowledge: Patients with multiple recanalizations and those with dynamically enlarging pseudoaneurysm or rapidly progressing anemia are at risk of life-threatening bleeding. An ultrasound-guided tissue glue injection, a novel method for the treatment of femoral artery pseudoaneurysm, might be considered as a treatment option especially in case of primary thrombin injection failure.