Repeated Percutaneous Thrombin Injections as Treatment of a Large Iatrogenic Pseudoaneurysm in the Artery Supplying a Haemodialysis Arteriovenous Fistula

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NR Mahboobani, LF Cheng, JKF Ma

Hong Kong J Radiol 2018;21:e12-7

DOI: 10.12809/hkjr1816431

We report a case of obliteration of a large radial artery pseudoaneurysm complicating venous angioplasty in a patient with a left forearm Brescia-Cimino fistula. Obliteration was by combined balloon-assisted and ultrasound-guided direct percutaneous thrombin injections. The procedure was performed twice. There was subsequent salvage of the fistula with restoration of function and minimal cosmetic disfiguration following subsequent pseudoaneurysm shrinkage. This procedure provides a safe treatment of such complications and can be repeated. We describe the procedure and its advantages and discuss other treatment options.


Author affiliation(s):
NR Mahboobani, LF Cheng, JKF Ma: Department of Radiology, Princess Margaret Hospital, Laichikok, Hong Kong