Endovascular Balloon Occlusion in the Management of an Iatrogenic Superficial Femoral Artery Pseudoaneurysm

Iatrogenic arterial injuries, especially those leading to pseudoaneurysms, are common complications following percutaneous vascular access and interventional procedures. While small pseudoaneurysms may resolve spontaneously or be managed conservatively with observation and serial ultrasound follow-ups, larger or more complex pseudoaneurysms often require more advanced interventions. Ultrasound-guided compression (UGC) is a widely used first-line treatment due to its simplicity, non-invasive nature, and cost-effectiveness. However, its success is limited, particularly in the case of wide-neck pseudoaneurysms, as seen in this report. In a case where UGC failed to achieve thrombosis in a multilobed, wide-neck pseudoaneurysm, endovascular balloon occlusion was employed. This technique involved temporarily inflating a balloon at the pseudoaneurysm neck, effectively reducing blood flow to the sac and promoting thrombosis. The procedure successfully occluded the pseudoaneurysm, minimizing the risk of distal embolization and preventing the need for open surgical repair. This minimally invasive approach offers a promising alternative for the management of iatrogenic femoral artery pseudoaneurysms, particularly when conventional methods fail. The technique not only avoids the risks associated with surgery but also demonstrates a high level of efficacy in inducing thrombosis, ensuring the preservation of distal arterial flow and avoiding significant morbidity. This case underscores the utility of endovascular balloon occlusion in treating complex pseudoaneurysms and highlights its potential as a preferred method in certain clinical settings.