Percutaneous occlusion of femoral artery pseudoaneurysm by para-aneurysmal saline injection

The increasing number of coronary interventions and more aggressive anticoagulation is associated with a larger number of iatrogenic femoral pseudoaneurysms (PAs). The majority of PAs clot spontaneously or can be repaired by ultrasound-guided compression or ultrasound-guided thrombin injection. The therapeutic armamentarium for the remaining PAs ranges from different interventional procedures to surgical occlusion. In a small case series, we describe our initial experiences with a new, less invasive approach after unsuccessful compression therapy. Ultrasound-guided injection of 52+/-33 ml saline beneath the communication tract of the PA yields to rapid occlusion in six consecutive patients. During 4 weeks of follow-up, the PAs remained occluded in all patients and surgical intervention could be avoided.