Endovascular management of traumatic pseudoaneurysm: Short & long term outcomes.

Background: Pseudoaneurysms as result of orthopaedic injuries are a known clinical entity. But with increase in operative interventions and use of implants, its incidence is bound to increase. It is important to detect this complication at the earliest to avoid any limb or life threatening problems. Selective angiography is a minimally invasive technique to pin point the diagnosis and at the same time allow for therapeutic embolization/stenting of the pseudo aneurysm.

Methods: A retrospective review of inpatients from January 2007 to January 2013 requiring transarterial embolization/stenting for pseudoaneurysm in the limbs. All patients had evidence of pseudoaneurysm as proved by radiological findings. Angiographic intervention in a cath lab was performed, following which patients were monitored for morbidity and mortality benefits on short and long term follow up.

Results: Out of the total 13 patients; 7 adults and 1 child underwent embolisation with polyvinyl alcohol particle/soft metal coil, whereas the remaining 5 adults underwent revascularisation with covered stent. The mean age of patients in our case series was 41.92 ± 18.89 years. The mean follow up period of the group was 14.61 ± 12.21 months. All but one patients showed significant clinical improvement with endovascular management with no procedure related mortality.

Conclusion: Endovascular management is the modality of choice in comparison to other procedures for traumatic pseudoaneurysms in both paediatric and adult patients.