title: Non Surgical Management of Pseudoaneurysms.
abstract: BACKGROUND
  The incidence of pseudoaneurysm has increased due to the large number of vascular procedures performed and the widespread use of anticoagulation therapy during procedures. Non-invasive methods for management of pseudoaneurysms comprise of ultrasound guided compression (USGC), thrombin therapy, arterial embolisation and endovascular stent graft insertion. We discuss our experience in the management of fourteen cases of pseudoaneurysms using non surgical techniques.
  
  
  METHODS
  During a two year period, fourteen patients presenting with pseudoaneurysms of different regions were treated.
  
  
  RESULTS
  Of the fourteen patients, eleven were iatrogenic and three were attributable to trauma. There were six cases of pseudoaneurysms of the femoral artery following coronary angiography studies. One patient developed pseudoaneurysm of right popliteal artery after external fixation of fracture right tibia and fibula. Three cases of renal artery pseudoaneurysms occurred following percutaneous nephrolithotomy (PCNL). The cases were evaluated using a varying combination of color doppler, multidetector computerised tomography (CT) and angiography. These cases were treated with ultrasound guided compression (USGC), stent graft and coil embolisation. The selection of method was based on the location and size of pseudoaneurysms besides the efficacy of the technique. USGC was performed in seven, of which six were in the femoral artery and one supraorbital. The technique was unsuccessful in three of the seven, wherein stent graft was deployed in the femoral artery. Coil embolisation was utilised in three cases of renal artery pseudoaneurysms following PCNL.
  
  
  CONCLUSIONS
  Follow up with color doppler and CT angiography within a week, 6 and 12 months period showed successful regression of pseudoaneurysms in all cases.
authors.affiliation: Senior Advisor (Radiodiagnosis and Imaging), Army Hospital (R&R), Delhi Cantt.
authors.forename: J
authors.initials: J
authors.lastname: D'Souza
authors.affiliation: Senior Advisor (Surgery and Vascular Surgery), Army Hospital (R&R), Delhi Cantt.
authors.forename: V S
authors.initials: VS
authors.lastname: Bedi
authors.affiliation: Classified Specialist (Radiodiagnosis and Imaging), AH (R&R).
authors.forename: I K
authors.initials: IK
authors.lastname: Indrajit
authors.affiliation: Reader (Radiodiagnosis and Imaging), AFMC, Pune 411 040.
authors.forename: R
authors.initials: R
authors.lastname: Pant
keywords: Arterial trauma; Coil embolisation; Endovascular stent graft; Pseudoaneurysm; Ultrasound guided compression