Peripheral Pseudoaneurysms

Peripheral pseudoaneurysms are a frequent vascular complication that may occur as a consequence of traumatic injuries, infections, or iatrogenic procedures. Pseudoaneurysms are aberrant protrusions in a blood vessel that are generated by a disruption in the vessel wall. They can present in various parts of the vasculature and have the potential to cause significant morbidity if left untreated. Percutaneous and endovascular interventions are becoming more recognized as effective treatment for peripheral pseudoaneurysms, leading to reduction in morbidity and improvement of patient outcomes. Percutaneous interventions, such as ultrasound-guided compression, thrombin injection, or mechanical compression, entail the external induction of thrombosis. For pseudoaneurysms of a small to moderate size, these methods have been found to be safe and efficacious, with low recurrence rates. However, larger, and more complex, pseudoaneurysms may necessitate endovascular methods, such as stent-graft placement or coil embolization, which are minimally invasive procedures executed under fluoroscopy guidance. These approaches offer distinct advantages over conventional surgical procedures, including shorter hospital stays, faster recovery, and decreased complication rates. The choice of intervention should be individualized based on the patient’s clinical condition as well as the anatomical features (size, location, complexity) of the pseudoaneurysm, with careful monitoring for post-procedural outcomes and optimal long-term treatment outcomes. This chapter serves as an overview of percutaneous and endovascular procedures that are used for the management of peripheral pseudoaneurysms.