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Pseudoaneurysms and the Role of Minimally Invasive Techniques in Their Management¹

¹ From the Departments of Radiology (N.E.A.S., W.E.A.S., D.L.W., P.J.F., D.J.R.) and Vascular Surgery (M.G.D.), University of Rochester Medical Center, 601 Elmwood Ave, Box 648, Rochester, NY 14642. Presented as an education exhibit at the 2004 RSNA Annual Meeting. Received February 1, 2005; revision requested March 22 and received April 28; accepted May 17. All authors have no financial relationships to disclose. Address correspondence to N.E.A.S. (e-mail: nael{at}mindless.com).

Pseudoaneurysms are common vascular abnormalities that represent a disruption in arterial wall continuity. Some complications associated with pseudoaneurysms develop unpredictably and carry high morbidity and mortality rates. The advent of new radiologic techniques with a greater sensitivity for asymptomatic disease has allowed more frequent diagnosis of pseudoaneurysms. Conventional angiography remains the standard of reference for diagnosis but is an invasive procedure, and noninvasive diagnostic modalities (eg, ultrasonography [US], computed tomographic angiography, magnetic resonance angiography) should be included in the initial work-up if possible. A complete work-up will help in determining the cause, location, morphologic features, rupture risk, and clinical setting of the pseudoaneurysm; identifying any patient comorbidities; and evaluating surrounding structures and relevant vascular anatomy, information that is essential for treatment planning. Therapeutic options have evolved in recent years from the traditional surgical option toward a less invasive approach and include radiologic procedures such as US-guided compression, US-guided percutaneous thrombin injection, and endovascular management (embolization, stent-graft placement). The use of noninvasive treatment has led to a marked decrease in the morbidity and mortality rates for pseudoaneurysms.

© RSNA, 2005

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