What Is a Pseudoaneurysm Repair?

A pseudoaneurysm is a leak from an artery into the surrounding tissue. Blood collects in a sac that stays connected to the artery by a narrow channel, called the neck. It is not a true aneurysm. A true aneurysm is a bulge of the artery wall itself. Surrounding tissue contains the pseudoaneurysm sac.

It often appears in the groin after a heart or vascular catheter procedure, when the puncture in the femoral artery does not seal. It can also occur in the arm or at another access site. Ultrasound shows blood flowing in and out of the sac.

Interventional radiology usually treats it with an ultrasound-guided injection of thrombin, a medicine that helps blood clot. Sometimes, doctors use ultrasound-guided pressure on the neck instead. A covered stent or surgery is reserved for a sac that cannot be closed safely with injection or pressure.

Why Do I Need It?

A pseudoaneurysm may be treated when:

• A tender, pulsatile lump, growing bruise, or pain appears at a recent puncture site
• The sac is large, still open on ultrasound, or growing
• It is pressing on a nearby nerve or vein, or the skin over it is threatened
• There is a risk it will keep bleeding into the tissue

Some small pseudoaneurysms close on their own over days to weeks. Observation is used only when your team judges it safe, with follow-up ultrasound. In most selected cases, treatment closes the leak without open surgery.

How Do I Prepare?

• Medicines: Tell the team about blood thinners, antiplatelet medicines, and every other medicine and supplement. Do not stop a medicine unless you are told to.
• Allergies and history: Report allergies to numbing medicine, contrast, latex, or thrombin. Tell the team if you have received thrombin before. Also report a bleeding problem or infection near the site.
• Checks: You may need blood tests. The team will check the pulses in the foot or hand beyond the site, before and after treatment.
• Eating and support: Many visits use only numbing medicine. Follow fasting instructions if sedation is planned. Arrange a ride home if you are told not to drive.
• Clothing: Wear clothes that give easy access to the groin or arm site. Do not put cream or powder on the area.

How Is It Done?

• You lie flat. The skin is cleaned. Numbing medicine is given. You stay awake. Sedation is not always used.
• Ultrasound shows the sac, the neck, and the artery. A thin needle is guided into the sac, away from the neck.
• The team injects thrombin slowly while monitoring the flow with ultrasound. The sac usually clots within seconds to a few minutes. You may feel pressure. A second injection is sometimes needed.
• If injection is not the plan, the team may apply ultrasound-guided pressure on the neck for a period of time instead.
• The team confirms the sac has stopped flowing and that the artery itself stays open. The team checks the pulse beyond the site. A bandage is placed.
• The visit often takes 30 to 60 minutes, plus a short observation period. Most people go home the same day.

Care Instructions

• Rest for the rest of the day. Limit stairs, squatting, bending at the groin, and heavy lifting for several days, or as your team directs.
• A bruise and mild soreness are common. Keep the dressing clean and dry. Change it if it becomes wet or loose. You may shower when told it is safe. Do not soak the site until cleared.
• Restart blood thinners only if you are told to. Do not massage the site.
• Keep the follow-up ultrasound. That visit confirms the sac has stayed closed and the artery is open. A repeat injection is sometimes needed if flow returns.

What to Watch For

Call your care team promptly if you notice:

• The lump returns, or the bruise spreads quickly
• Pain that is getting worse, or new numbness near the site
• Redness, warmth, drainage, or fever
• A pale, cool, numb, or weak leg or arm, or a pulse that is hard to feel beyond the site — call right away

Seek emergency care for bleeding that will not stop, sudden severe pain, chest pain, trouble breathing, fainting, or a limb that becomes cold and pale. Rarely, clot medicine can affect the artery itself. That is why checking your pulse matters.