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

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

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.

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.

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.