What causes a pseudoaneurysm? Should a pseudoaneurysm always be treated?

Answer From Rekha Mankad, M.D.

A pseudoaneurysm, sometimes called a false aneurysm, occurs when a blood vessel wall is injured, and the blood is contained by the surrounding tissues. In a true aneurysm, the artery or vessel is dilated, sometimes causing a blood-filled sac to form.

Both aneurysms and pseudoaneurysms can occur within the heart. Their formation is typically related to complications after a heart attack.

A pseudoaneurysm may also be a complication of cardiac catheterization, a procedure in which a thin, flexible tube (catheter) is inserted in an artery in your groin (femoral artery) and is threaded through your blood vessels to your heart. Cardiac catheterization is generally used to diagnose heart disease and to treat certain types of heart disease.

A pseudoaneurysm can result from cardiac catheterization if blood leaks and pools outside your femoral artery where it was punctured when the catheter was inserted. Pseudoaneurysms can also occur in other arteries throughout the body. These pseudoaneurysms may be related to surgery, trauma, infection or the rupture of an aneurysm.

If a pseudoaneurysm of a femoral artery related to cardiac catheterization is small, it may go undetected and not cause any complications. But if a small pseudoaneurysm is detected, your doctor may recommend a watchful-waiting approach to see if it resolves on its own.

However, most often when a femoral artery pseudoaneurysm is detected, your doctor will recommend one of these treatments:

  • Ultrasound-guided compression repair. In this treatment, your doctor will look for your pseudoaneurysm using ultrasound imaging. Once the pseudoaneurysm is found, your doctor presses on it to release the built-up blood.
  • Ultrasound-guided medication. In this treatment, your doctor uses ultrasound imaging to locate and inject a blood clot-forming medication (thrombin) into the pseudoaneurysm. The medication causes the pooled blood to clot.
  • Surgery. If your doctor doesn't think either ultrasound-guided treatment will work, he or she may recommend surgery to correct it.

With

Rekha Mankad, M.D.

Aug. 22, 2015 See more Expert Answers