1998 SCVIR Gary J. Becker Young Investigator Award. Endovascular repair of arterial pseudoaneurysms with use of a perfusion balloon catheter.
OBJECTIVE
Pseudoaneurysms represent contained disruption of the arterial wall. Iatrogenic pseudoaneurysms frequently complicate complex endovascular procedures. With use of an animal model, the authors attempted to determine the safety and efficacy of using a perfusion balloon catheter (PBC) to thrombose surgically created pseudoaneurysms.


METHODS
An in vitro system measured maximum flow volume through a 5-F PBC. Pseudoaneurysms were created in domestic swine with use of a jugular vein patch anastomosed to a femoral arteriotomy. The PBC was inflated across the pseudoaneurysm neck for 30-minute intervals until thrombosis was confirmed by ultrasound. Completion arteriography was performed to evaluate for vascular complications.


RESULTS
Maximum flow through the PBC was 62.6 mL/min measured at a constant pressure gradient of 120 mm Hg. Five pseudoaneurysms were created in four animals. The PBC completely thrombosed all five lesions. The mean treatment duration was 129 minutes (+/- 39 minutes SD). No native arterial injury, in situ thrombus, or distal embolization occurred. Partial recanalization of three of the five treated pseudoaneurysms was identified on follow-up arteriography and gross sectioning (n = 2 and n = 1, respectively).


CONCLUSIONS
The PBC safely and effectively thrombosed surgically created pseudoaneurysms. Partial recanalization of treated pseudoaneurysms was demonstrated. Clinical trials are warranted.
Moresco
K
K
Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA.
Bonn
J
J
DiMuzio
P
P
Consigny
P M
PM
D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D000818:Animals; D001363:Awards and Prizes; D002404:Catheterization; D002406:Catheterization, Peripheral / Q000009:adverse effects; D004621:Embolization, Therapeutic; D005263:Femoral Artery / Q000473:pathology; D015641:Radiography, Interventional; D012955:Societies, Medical; D013552:Swine; D013927:Thrombosis