Abstract
Traumatic pseudoaneurysms develop due to disruption of the intima and media and lack
an epithelialized wall; instead, there is a thin rim of fibrous tissue. While spontaneous
thrombosis and regression have been described, traumatic pseudoaneurysms typically
require treatment due to the high risk of rupture. As opposed to true aneurysms, pseudoaneurysm
size is a poor surrogate for rupture risk. A variety of endovascular and percutaneous
techniques exist to safely and definitively treat pseudoaneurysms. The goal is to
exclude the pseudoaneurysm to eliminate the risk of rupture while avoiding nontarget
embolization and preserving unexpendable arteries. In trauma scenarios, it is often
difficult to have a complete evaluation of the relevant anatomy with key considerations
including the pseudoaneurysm size and neck, the necessity of preserving the target
artery, and the presence of collateral arteries. The following cases illustrate the
variety of techniques available for pseudoaneurysm treatment, their relative merits,
and key considerations.
Keywords
trauma - pseudoaneurysm - embolization
