Radiology Imaging, Diagnostic Imaging, Medical Imaging News, Education, Resources

History:

44 year old man recently underwent fistula placement for hemodialysis access. Two weeks after surgery an enlarging mass in region of surgical site appeared.

Treatrment

Below, balloon being deployed

Brachial Artery Pseudoanurysm:

Pseudoaneurysms are quite common after trauma to the extremities and neck. Other common areas for Pseudoaneurysms include the arteries to the GI tract after pancreatitis or GI ulcers, or in the liver and kidneys after biopsies and drainage procedures.

Imaging:

Pseudoaneurysms can be imaged with CT, MR, angiography and ultrasound. They tend to have characteristic appearance on ultrasound, a biphasic flow pattern.

Therapy:

Preferred therapy is operative. Barring that, other choices include:

• US probe compression
• thrombin injection
• coils
• detachable balloons
• tissue adhesives

Only consider embolotherapy if the neck of the pseudoaneurysm is narrow. If a wide gap exists then likelyhood of embolizing agent going elsewhere exists.

Other examples of Pseudoaneurysm: