Percutaneous balloon-assisted ultrasound-guided direct thrombin embolization of superficial femoral artery pseudoaneurysm: a case series and literature review

• Published in: CVIR endovascular Vol. 7; no. 1; p. 19
• Main Authors: Bruno, Antonio, Vendetti, Francesco, Papalexis, Nicolas, Russo, Mattia, Papadopoulos, Dimitris, Mosconi, Cristina
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 16-02-2024; Springer Nature B.V; SpringerOpen
• Subjects: Balloon; Case Report; Imaging; Injection; Interventional Radiology; Medicine; Medicine & Public Health; Pseudoaneurysm; Radiology; Superficial femoral artery; Thrombin; Ultrasonic imaging; Ultrasound; Superficial femoral artery; Ischemia; Thrombin; Balloon; Injection; Ultrasound; Pseudoaneurysm
• ISSN: 2520-8934; 2520-8934
• DOI: 10.1186/s42155-024-00428-8

Background
Superficial femoral artery (SFA) pseudoaneurysms, a rare but potentially life-threatening complication, that can arise after vascular interventions or trauma. This case series explores the efficacy and safety of a minimally invasive treatment modality, percutaneous ultrasound-guided thrombin injection (PUGTI) combined with balloon occlusion, in three patients with SFA pseudoaneurysms.
Case presentation
Three patients (age: 71–82 years; 3 female) with SFA pseudoaneurysms underwent PUGTI with balloon occlusion. The procedure involved direct thrombin injection under ultrasound guidance while occluding the parent artery using a balloon catheter. Follow-up was conducted at 1 week and 1 month post-procedure to assess technical success, complications, and recurrence.
Conclusion
PUGTI combined with balloon occlusion appears to be a safe and effective treatment for SFA pseudoaneurysms, particularly for larger pseudoaneurysms. The procedure is associated with a high technical success rate. Balloon occlusion may offer a safer alternative to direct thrombin injection without occlusion, as it potentially minimizes the risk of complications such as distal thromboembolism.